For patients presenting to the emergency department with life-threatening injuries, rapid diagnosis and immediate treatment are essential to preventing further complications and untimely death. Multidetector computed tomography (MDCT) is beneficial in evaluating anatomy and has become the gold standard for diagnostic imaging of patients with trauma. Many reasons are related to its core strengths: speed, specificity, and accuracy. However, many factors may impact the quality of imaging when using MDCT and, ultimately, its utility in the trauma setting.
This article discusses implications for, as well as common findings from, the most common MDCT examinations performed in patients with traumatic injury. The use of and risks associated with intravenous iodinated contrast material is addressed, although a more thorough discussion of iodinated contrast usage is beyond the scope of this article. This article reviews aspects of MDCT in pediatric patients with trauma, for example, balancing the benefits of imaging and risks of radiation exposure, ensuring patient compliance during the examination, and exploring the differences between the adult and the pediatric patient. Common pitfalls in trauma imaging are presented along with strategies to mitigate them. Finally, this article examines the role of the CT technologist in assuring a high-quality diagnostic examination, and discusses the most variable, and arguably most important, factor in trauma imaging: anticipating the unexpected and challenging circumstances that constantly occur in trauma cases.
After reading this article, the participant should be able to:
- Discuss the advantages of multidetector computed tomography (MDCT) compared to radiography in the trauma setting.
- Examine implications for and common findings of MDCT examinations performed on different anatomical regions of patients with trauma.
- Assess how to manage the challenges of imaging pediatric patients with trauma.
- Understand the role of the CT technologist in the trauma imaging suite.
Categories: Computed Tomography, Quality Management