title: CT Chest with IV Contrast Compared with CT Angiography after Blunt Trauma.
abstract: Blunt aortic injury (BAI) after chest trauma is a potentially lethal condition that requires rapid diagnosis for appropriate treatment. We compared CT with IV contrast (CTI) with CT with angiography (CTA) during the initial phase of care at an urban Level I trauma center from January 1, 2010 to December 31, 2013. Overall, 281 patients met inclusion criteria with 167 (59%) CTI and 114 (41%) CTA. There were no differences between cohorts in age, gender, initial heart rate, systolic blood pressure, and Glasgow Coma Scale. Mortality rates were similar for CTI and CTA (4% vs 8%, P = 0.20). CTI identified any chest injury in 54 per cent of patients compared with 46 per cent with CTA (P = 0.05). The rate of BAI was similar with CTI and CTA (2% vs 2%, P = 0.80), and neither modality was falsely negative. We conclude that CTI and CTA are similar at evaluating trauma patients for BAI, although CTI may be preferable during the initial assessment phase because the contrast injection may be combined with abdominal scanning and image time is reduced when whole-body CT is required.
authors.affiliation: Division of Trauma and Critical Care, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California, USA.
authors.forename: Andrea A
authors.initials: AA
authors.lastname: Zaw
authors.forename: Donovan
authors.initials: D
authors.lastname: Stewart
authors.forename: Jason S
authors.initials: JS
authors.lastname: Murry
authors.forename: David M
authors.initials: DM
authors.lastname: Hoang
authors.forename: Beatrice
authors.initials: B
authors.lastname: Sun
authors.forename: Sogol
authors.initials: S
authors.lastname: Ashrafian
authors.forename: Heidi
authors.initials: H
authors.lastname: Hotz
authors.forename: Rex
authors.initials: R
authors.lastname: Chung
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Margulies
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Ley
mesh_terms: D000328:Adult; D000792:Angiography / Q000379:methods*; D002140:California / Q000453:epidemiology; D003287:Contrast Media; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D013902:Radiography, Thoracic / Q000379:methods*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013898:Thoracic Injuries / Q000000981:diagnostic imaging* / Q000401:mortality; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014193:Trauma Centers; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging* / Q000401:mortality
chemical_list: D003287:Contrast Media