[Thoracic CT scan in intensive care unit patients: information supplementary to thoracic radiography].
OBJECTIVE
To assess the diagnostic value of thoracic CT-scans in comparison with conventional chest radiographs in ICU-patients.


METHODS
Chest radiographs and corresponding thoracic CT-scans of 25 consecutive surgical ICU-patients were reviewed and interpreted independently by two radiologists. We analyzed the additional information provided by CT-scans and the diagnostic and therapeutic relevance of these findings.


RESULTS
In 22 patients (88%), thoracic CT revealed 35 single additional findings, in comparison with the corresponding bedside radiographs. In 7 cases (28%), these findings (tube-malpositioning, mediastinitis, mediastinal abscess and pneumothorax) required modification of patient management. Of 7 patients with tube thoracostomy, 3 tubes were malpositioned, which was only depicted on CT-scans. In 10 of 21 cases (48%), pleural effusions could only be visualized by CT. 3 of 5 (60%) pneumothoraces were detected by CT-scans only. There were no significant complications during transport or CT-examination.


CONCLUSIONS
Thoracic CT may provide significant information in addition to plain chest radiographs, particularly when specific problems or questions, referring to the management of ICU-patients, arise.
Fuchsjäger
M
M
Universitätsklinik für Radiodiagnostik der Universität Wien, AKH-Wien, Osterreich. Michael.Fuchsjaeger@akh-wien.ac.at
Hörmann
M
M
Germann
P
P
Lechner
G
G
Herold
C
C
D000038:Abscess / Q000000981:diagnostic imaging; D000293:Adolescent; D000328:Adult; D000368:Aged; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008477:Mediastinal Diseases / Q000000981:diagnostic imaging; D008480:Mediastinitis / Q000000981:diagnostic imaging; D008875:Middle Aged; D011030:Pneumothorax / Q000000981:diagnostic imaging; D013902:Radiography, Thoracic; D013907:Thoracostomy; D014057:Tomography, X-Ray Computed