CT evaluation of the low severity cervical spine trauma: when is the scout view enough?
The aim of the current study was to compare the diagnostic information obtained from a helical CT examination in low severity cervical spine trauma with that from a lateral CT scout view. We included alert and clinically stable patients, who had suffered acute blunt trauma of low or moderate severity. Their scout images were interpreted independently by two radiologists and the final outcome of the CT exam which was the gold standard. Patient dose was assessed using Monte-Carlo techniques. In 52 of our studies (45%), at least the first five cervical vertebrae were visible with adequate quality, and in 16.5% of the scout views (19 studies) all 7 vertebrae were depicted with excellent quality. Overall sensitivity and specificity of scout view was 70% and 100%, respectively. There were three false negative and one false positive cases. The effective dose value was estimated to be 0.02 mSv which is at least two orders of magnitude lower than that from a CT scan. When clinical examination is not suggestive of a C1-C2 fracture, adequate depiction of an intact cervical spine at the scout view, without proceeding to a full CT scan, is a sufficient dose and time-effective imaging approach.
Theocharopoulos
Nicholas
N
Department of Medical Physics, Faculty of Medicine, University of Crete, P.O. Box 2208, Iraklion 71003, Crete, Greece.
Chatzakis
Georgios
G
Karantanas
Apostolos
A
Chlapoutakis
Konstantinos
K
Damilakis
John
J
D000368:Aged; D000369:Aged, 80 and over; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging* / Q000293:injuries*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013124:Spinal Injuries / Q000000981:diagnostic imaging*; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging*