[Acute diagnosis of thoracic injuries of therapeutic relevance in severely injured and polytraumatized patients].
OBJECTIVE
To determine the value of supine chest radiography in comparison to orientating chest CT in the initial diagnostic evaluation of severely polytraumatised patients.


METHODS
303 patients with primary indication for a cranial CT following trauma were investigated between 1988 and 1993. After performing the cranial CT all patients underwent a chest CT with an average of 6 CT slices without changing the position of the patient and with a median scan time of 4 minutes. The results of the chest CT were correlated with the findings of the supine chest radiography in regard to therapeutically relevant pathological changes.


RESULTS
The sensitivity in detection of pneumothorax in supine chest radiography was 53% versus 97% in CT, atelectasis 20% versus 94%, lung contusion 79% versus 99%, haemotothorax 62% versus 97%. More fractures were found conventionally (sensitivity 94%) than by chest CT (sensitivity 44%).


CONCLUSIONS
Supine chest radiography of polytraumatised patients is clearly inferior to orientating chest CT in demonstrating posttraumatic lesions; obtaining therapeutically relevant information justifies the additionally needed small amount of time.
Danz
B
B
Radiologische Abteilung, Bundeswehrkrankenhaus Ulm.
Biehl
C
C
Bähren
W
W
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003288:Contusions / Q000000981:diagnostic imaging; D005260:Female; D050723:Fractures, Bone / Q000000981:diagnostic imaging; D006491:Hemothorax / Q000000981:diagnostic imaging; D006801:Humans; D055370:Lung Injury; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000000981:diagnostic imaging*; D011030:Pneumothorax / Q000000981:diagnostic imaging; D001261:Pulmonary Atelectasis / Q000000981:diagnostic imaging; D012680:Sensitivity and Specificity; D013898:Thoracic Injuries / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed
Zur Akutdiagnostik therapierelevanter Thoraxverletzungen bei schwer- und polytraumatisierten Patienten.