Whole-body computed tomography for multiple traumas using a triphasic injection protocol

Eur Radiol. 2008 Jun;18(6):1206-14. doi: 10.1007/s00330-008-0875-3. Epub 2008 Feb 13.

Abstract

To evaluate a triphasic injection protocol for whole-body multidetector computed tomography (MDCT) in patients with multiple trauma. Fifty consecutive patients (41 men) were examined. Contrast medium (300 mg/mL iodine) was injected starting with 70 mL at 3 mL/s, followed by 0.1 mL/s for 8 s, and by another bolus of 75 mL at 4 mL/s. CT data acquisition started 50 s after the beginning of the first injection. Two experienced, blinded readers independently measured the density in all major arteries, veins, and parenchymatous organs. Image quality was assessed using a five-point ordinal rating scale and compared to standard injection protocols [n = 25 each for late arterial chest, portovenous abdomen, and MDCT angiography (CTA)]. With the exception of the infrarenal inferior caval vein, all blood vessels were depicted with diagnostic image quality using the multiple-trauma protocol. Arterial luminal density was slightly but significantly smaller compared to CTA (P < 0.01). Veins and parenchymatous organs were opacified significantly better compared to all other protocols (P < 0.01). Arm artifacts reduced the density of spleen and liver parenchyma significantly (P < 0.01). Similarly high image quality is achieved for arteries using the multiple-trauma protocol compared to CTA, and parenchymatous organs are depicted with better image quality compared to specialized protocols. Arm artifacts should be avoided.

MeSH terms

  • Adult
  • Analysis of Variance
  • Contrast Media / administration & dosage*
  • Female
  • Humans
  • Injections, Intravenous
  • Iohexol / administration & dosage
  • Iohexol / analogs & derivatives*
  • Male
  • Middle Aged
  • Multiple Trauma / diagnostic imaging*
  • Retrospective Studies
  • Tomography, X-Ray Computed / methods*
  • Whole Body Imaging*

Substances

  • Contrast Media
  • Iohexol
  • iopromide