Elizabeth Knoff, RT(R)*
*Computed Tomography Technologist, CJW Medical Center, Chippenham Hospital, Richmond, VA.
Address correspondence to: Elizabeth Knoff, RT(R)(CT), Computed Tomography Technologist, CJW Medical Center, Chippenham Hospital, 7101 Jahnke Rd, Richmond, VA 23225. Ph: 804.323.8558. Email: Elizabeth.Knoff@hcahealthcare.com.
Disclosure Statement: Ms Knoff reports having no significant financial or advisory relationships with corporate organizations related to this activity.
Assistance with updates to this article provided by Elizabeth Adams, MPH.
For patients presenting to the emergency department with life-threatening injuries, rapid diagnosis and immediate treatment are essential to preventing further complications or 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 attributes are related to its core strengths: speed, specificity, and accuracy. However, several factors may impact the quality of imaging and, ultimately, the utility of MDCT 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 are addressed, although a more thorough discussion of iodinated contrast usage is beyond the scope of this article. In addition, aspects related to use of MDCT in pediatric patients are reviewed, 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.
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