Splenic parenchymal heterogeneity at dual-bolus single-acquisition CT in polytrauma patients-6-months experience from Oxford, UK.

Dual-bolus single-acquisition CT (DBSA-CT) has been advocated in the work up of polytrauma cases, providing rapid acquisition and simultaneous visceral and vascular assessment. Splenic heterogeneity has been observed with this technique. The aim of this study was to investigate this phenomenon and assess predisposing factors and impact on image interpretation through a 6-month retrospective audit between March and September 2011. Seventy-three polytrauma patients underwent standardized DBSA-CT. Splenic enhancement was assessed quantitatively using ROIs and image quality using a 5-point visual analog scale; a score of ≥3 was considered diagnostic. Hematoma density was measured in splenic injuries. Age, hemodynamic status, and aortic density were investigated as predictors of splenic heterogeneity. Seventy-three patients were imaged with 98.6 % blunt traumas. There were 5 (6.9 %) splenic injuries. Eight (11 %) had coexisting visceral and vascular injuries.