title: Whole-body computed tomography for multiple traumas using a triphasic injection protocol.
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.
authors.affiliation: Institute for Diagnostic, Interventional and Pediatric Radiology, Inselspital Berne, Freiburgstrasse 10, CH-3010 Berne, Switzerland.
authors.forename: Christos
authors.initials: C
authors.lastname: Loupatatzis
authors.forename: Sebastian
authors.initials: S
authors.lastname: Schindera
authors.forename: Jan
authors.initials: J
authors.lastname: Gralla
authors.forename: Hanno
authors.initials: H
authors.lastname: Hoppe
authors.forename: Jan
authors.initials: J
authors.lastname: Bittner
authors.forename: Ralph
authors.initials: R
authors.lastname: Schröder
authors.forename: Sudesh
authors.initials: S
authors.lastname: Srivastav
authors.forename: Harald Marcel
authors.initials: HM
authors.lastname: Bonel
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D003287:Contrast Media / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D007472:Iohexol / Q000008:administration & dosage / Q000031:analogs & derivatives*; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*; D051598:Whole Body Imaging
chemical_list: D003287:Contrast Media; D007472:Iohexol; C038192:iopromide