Top

Published in:

01-10-2004 | Computer Tomography

Traumatic injuries of the pelvis and thoracic and lumbar spine: does thin-slice multidetector-row CT increase diagnostic accuracy?

Authors: C. Herzog, H. Ahle, M. G. Mack, B. Maier, W. Schwarz, S. Zangos, V. Jacobi, A. Thalhammer, J. Peters, H. Ackermann, T. J. Vogl

Published in: European Radiology | Issue 10/2004

Abstract

The objective is to evaluate different multidetector-row CT (MDCT) strategies for adequate classification of spinal and pelvic injuries. Seventy intubated patients after multiple trauma underwent conventional radiography (CR) and MDCT. Examinations included the pelvis (P), the lumbar spine (LS) and the thoracic spine (TS). Conventional radiographs, 3-mm (CT5) and 5-mm scans (CT3) and 3-mm and 5-mm scans combined with MPR (CT3R/CT5R) were compared to surgery, autopsy and clinical course. MDCT led to significantly better results than CR (P<0.01). Correlation coefficients were r=1.0 (CT3R), r=0.96 [TS] to r=1.0 [P/LS] (CT5R), r=0.8 [P] to r=1.0 [TS] (CT3), r=0.80 [P] to r=0.86 [TS] (CT5) and r=0.3 [TS] to r=0.69 [P] (CR). Fractures were identified by CT3R in 100% of cases, by CT5R in 95%, by CT3 in 90% [P]−100% [TS], by CT5 in 83.3% [LS]−90% [P] and by CR in 57.1% [TS]−87.2% [P]. Unstable fractures were identified in 100% by CT3R, CT5R and CT3, 85.7% [TS]−100% [P/LS] by CT5 and 57.1% [TS]−80% [P] by CR. Only overlapping thin-slice multiplanar reformation allows for an adequate classification of spinal and pelvic injuries and thus is highly emphasized in patients after severe blunt trauma.

Flohr T, Stierstorfer K, Bruder H, Simon J, Polacin A, Schaller S (2003) Image reconstruction and image quality evaluation for a 16-slice CT scanner. Med Phys 30:832–845CrossRefPubMed

Linsenmaier U, Krotz M, Hauser H, Rock C, Rieger J, Bohndorf K et al (2002) Whole-body computed tomography in polytrauma: techniques and management. Eur Radiol 12:1728–1740CrossRefPubMed

Wintermark M, Mouhsine E, Theumann N, Mordasini P, van Melle G, Leyvraz P et al (2003) Thoracolumbar spine fractures in patients who have sustained severe trauma: depiction with multi-detector row CT. Radiology 227:681–689PubMed

Wintermark M, Poletti P, Becker C, Schnyder P (2002) Traumatic injuries: organization and ergonomics of imaging in the emergency environment. Eur Radiol 12:959–968CrossRefPubMed

Magerl F, Aebi M, Gertzbein S, Harms J, Nazarian S (1994) A comprehensive classification of thoracic and lumbar injuries. Eur Spine J 3:184–201PubMed

Tile M (1984) Fractures of the pelvis and acetabulum. Wiliams & Wilkins, Baltimore

Theumann N, Verdon J, Mouhsine E, Denys A, Schnyder P, Portier F (2002) Traumatic injuries: imaging of pelvic fractures. Eur Radiol 12:1312–1330CrossRefPubMed

Rommens P, Vanderschot P, Broos P (1992) Conventional radiography and CT examination of pelvic ring fractures. A comparative study of 90 patients. Unfallchirurg 95:387–392PubMed

Daffner R (2001) Helical CT of the cervical spine for trauma patients: a time study. Am J Roentgenol 177:677–679

10.

Low R, Duber C, Schweden F, Lehmann L, Blum J, Thelen M (1997) Whole body spiral CT in primary diagnosis of patients with multiple trauma in emergency situations. Fortschr Rontgenstr 166:382–388

11.

Weishaupt D, Grozaj A, Willmann J, Roos J, Hilfiker P, Marincek B (2002) Traumatic injuries: imaging of abdominal and pelvic injuries. Eur Radiol 12:1295–1311CrossRefPubMed

12.

Schroder R, Albus M, Kandziora F, Herzog H, Rottgen R, Maurer J et al (2003) Diagnostic value of three-dimensional reconstruction in CT of traumatic spinal fractures. Fortschr Rontgenstr 175:1500–1507CrossRef

13.

Bensch F, Kiuru M, Koivikko M, Koskinen S (2004) Spine fractures in falling accidents: analysis of multidetector CT findings. Eur Radiol 14:618–624CrossRefPubMed

14.

Kalender W (2003) Computed Tomography. MCD, Munich

15.

Kosling S, Dietrich K, Steinecke R, Kloppel R, Schulz H (1997) Diagnostic value of 3D CT surface reconstruction in spinal fractures. Eur Radiol 7:61–64CrossRefPubMed

16.

Lehner K, von GS, Maurer J, Daschner H, Gerhardt P (1993) A comparison of plain film, axial CT, 2D and 3D reconstructions in unstable spinal injuries following surgery. Fortschr Rontgenstr 158:577–582

17.

Wedegartner U, Lorenzen M, Lorenzen J, Nolte-Ernsting C, Weber C, Dieckmann C et al (2004) Multislice CT of the pelvis: dose reduction with regard to image quality. Fortschr Rontgenstr 176:106–112CrossRef

18.

Robertson D, Sutherland C, Chan B, Hodge J, Scott W, Fishman E (1995) Depiction of pelvic fractures using 3D volumetric holography: comparison of plain X-ray and CT. J Comput Assist Tomogr 19:967–974PubMed

19.

Resnik C, Stackhouse D, Shanmuganathan K, Young J (1992) Diagnosis of pelvic fractures in patients with acute pelvic trauma: efficacy of plain radiographs. Am J Roentgenol 158:109–112

20.

Guillamondegui O, Pryor J, Gracias V, Gupta R, Reilly P, Schwab C (2002) Pelvic radiography in blunt trauma resuscitation: a diminishing role. J Trauma 53:1043–1047PubMed

21.

Rhee P, Bridgeman A, Acosta J, Kennedy S, Wang D, Sarveswaran J et al (2002) Lumbar fractures in adult blunt trauma: axial and single-slice helical abdominal and pelvic computed tomographic scans versus portable plain films. J Trauma 53:663–667PubMed

22.

Hauser C, Visvikis G, Hinrichs C, Eber C, Cho K, Lavery R et al (2003) Prospective validation of computed tomographic screening of the thoracolumbar spine in trauma. J Trauma 55:228–234PubMed

23.

Ptak T, Rhea J, Novelline R (2003) Radiation dose is reduced with a single-pass whole-body multi-detector row CT trauma protocol compared with a conventional segmented method: initial experience. Radiology 229:902–905PubMed

24.

Kalender W (2003) The use of flat-panel detectors for CT imaging. Radiologe 43:379–387CrossRefPubMed

25.

Pathria M, Petersilge C (1991) Spinal trauma. Radiol Clin North Am 29:847–865PubMed

26.

Denis F (1983) The three column spine and its significance in the classification of acute thoracolumbar spinal injuries. Spine 8:817–831PubMed

27.

Mirvis S (2003) Imaging in trauma and critical care. Elsevier, Amsterdam

Title: Traumatic injuries of the pelvis and thoracic and lumbar spine: does thin-slice multidetector-row CT increase diagnostic accuracy?
Authors: C. Herzog
H. Ahle
M. G. Mack
B. Maier
W. Schwarz
S. Zangos
V. Jacobi
A. Thalhammer
J. Peters
H. Ackermann
T. J. Vogl
Publication date: 01-10-2004
Publisher: Springer-Verlag
Published in: European Radiology / Issue 10/2004
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-004-2424-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Traumatic injuries of the pelvis and thoracic and lumbar spine: does thin-slice multidetector-row CT increase diagnostic accuracy?

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 10/2004

Prevalence of ovarian adrenal rest tumours and polycystic ovaries in females with congenital adrenal hyperplasia: results of ultrasonography and MR imaging

Comparison of flow artifacts between 2D-FLAIR and 3D-FLAIR sequences at 3 T

CT image in post-operative sepsis (2004:10a)

Computer-assisted detection of pulmonary nodules: performance evaluation of an expert knowledge-based detection system in consensus reading with experienced and inexperienced chest radiologists

Assessment of ventricular function and mass by cardiac magnetic resonance imaging

Lung coin lesions due to Echinococcal disease (2004:7b)