title: 64 MDCT in multiple trauma patients: imaging manifestations and clinical implications of active extravasation.
abstract: The finding of active hemorrhage on computed tomography (CT) in trauma patients has been shown to have significant clinical implications and has been incorporated into numerous CT grading schema. As CT technology has advanced, the sensitivity for detection of active hemorrhage in the trauma population has significantly improved. Currently, with the improved spatial and temporal resolution afforded by 64 multidetector computed tomography (64 MDCT) technology, the clinical implications of the CT findings of active extravasation may need to be reconsidered. This article illustrates the various imaging manifestations of active extravasation throughout the body using 64 MDCT. Additionally, protocol issues specific to the findings of active hemorrhage using 64 MDCT are detailed, including novel interpretation techniques, which offer aid in detecting and characterizing hemorrhage. Finally, the clinical implication of active extravasation using this new technology is discussed. Although more sensitive to the detection of small hemorrhagic foci and with clinical implications highly dependent upon location, active bleeding remains as a salient finding that affects subsequent clinical management of trauma patients.
authors.affiliation: Department of Radiology, Boston University Medical Center, 88 East Newton Street, 2nd Floor, Boston, MA 02215, USA. stephan.anderson@bmc.org
authors.forename: Stephan W
authors.initials: SW
authors.lastname: Anderson
authors.forename: Brian C
authors.initials: BC
authors.lastname: Lucey
authors.forename: James T
authors.initials: JT
authors.lastname: Rhea
authors.forename: Jorge A
authors.initials: JA
authors.lastname: Soto
mesh_terms: D000007:Abdominal Injuries / Q000000981:diagnostic imaging; D000792:Angiography / Q000379:methods; D003287:Contrast Media; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000000981:diagnostic imaging*; D006470:Hemorrhage / Q000000981:diagnostic imaging; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods; D009104:Multiple Trauma / Q000000981:diagnostic imaging*; D010388:Pelvis / Q000293:injuries; D011829:Radiation Dosage; D011856:Radiographic Image Enhancement / Q000379:methods; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014283:Triiodobenzoic Acids
chemical_list: D003287:Contrast Media; D014283:Triiodobenzoic Acids; C054871:ioversol