title: Diagnostic performance of abdominal CT for diagnosis of pelvic fractures: comparison with pelvic CT.
abstract: BACKGROUND
  In the emergency department, patients with abdominopelvic trauma inadvertently undergo both abdominal computed tomography (CT) (for intra-abdominal and intra-pelvic organs) and pelvic CT (CT with multiplanar reformation in three orthogonal planes of the bony pelvis). However, the systemic use of CT is concerning given the cumulative radiation dose.
  
  
  OBJECTIVE
  To evaluate the diagnostic value of abdominal CT in comparison to pelvic CT in patients with suspected pelvic fractures.
  
  
  METHODS
  Seventy-two patients who underwent abdominal CT and pelvic CT within a 2-week period to evaluate pelvic fractures were included. Two reviewers retrospectively analyzed eight anatomical regions of the pelvic bones on both abdominal CT and pelvic CT over a 1-week interval. The interpretation of pelvic CT scans by two senior musculoskeletal radiologists was considered as the reference standard. Diagnostic performance and inter-observer agreement of both CT scans were evaluated.
  
  
  RESULTS
  For reviewers 1 and 2, abdominal CT showed high accuracy (98% and 98%, respectively) as did pelvic CT. For both abdominal CT and pelvic CT, fracture detection in all anatomical regions of the pelvic bones was not significantly different for the two reviewers (P ≥ 0.25). Inter-observer agreement for all anatomical regions of the pelvic bones was excellent or good (k = 0.785-1.0).
  
  
  CONCLUSIONS
  Not only pelvic CT but also abdominal CT is acceptable for detection of pelvic fractures, in spite of its thicker sections and different reconstruction algorithm. Therefore, if abdominal CT has already been performed, additional pelvic CT might no longer be necessary in order to exclude a pelvic fracture.
authors.affiliation: Department of Radiology, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Republic of Korea.
authors.forename: Seong Jong
authors.initials: SJ
authors.lastname: Yun
authors.affiliation: Department of Radiology, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Republic of Korea jinooki@daum.net.
authors.forename: Wook
authors.initials: W
authors.lastname: Jin
authors.affiliation: Department of Radiology, National Police Hospital, Seoul, Republic of Korea.
authors.forename: So Hee
authors.initials: SH
authors.lastname: Yoon
authors.affiliation: Department of Orthopedic Surgery, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea.
authors.forename: Young Soo
authors.initials: YS
authors.lastname: Chun
authors.affiliation: Department of Radiology, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea.
authors.forename: Jang Gyu
authors.initials: JG
authors.lastname: Cha
authors.affiliation: Department of Radiology, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Republic of Korea.
authors.forename: Hye-Soo
authors.initials: HS
authors.lastname: Koo
authors.affiliation: Department of Radiology, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Republic of Korea.
authors.forename: So Young
authors.initials: SY
authors.lastname: Park
authors.affiliation: Department of Radiology, Kyung Hee University Medical Center, Seoul, Republic of Korea.
authors.forename: Ji Seon
authors.initials: JS
authors.lastname: Park
authors.affiliation: Department of Radiology, Kyung Hee University Medical Center, Seoul, Republic of Korea.
authors.forename: Kyung Nam
authors.initials: KN
authors.lastname: Ryu
authors.affiliation: Department of Emergency Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Republic of Korea.
authors.forename: Sun Hwa
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Department of Radiology, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Republic of Korea.
authors.forename: Jong Soo
authors.initials: JS
authors.lastname: Shin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D004636:Emergency Service, Hospital; D005260:Female; D050723:Fractures, Bone / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010384:Pelvic Bones / Q000000981:diagnostic imaging* / Q000293:injuries*; D011829:Radiation Dosage; D011857:Radiographic Image Interpretation, Computer-Assisted; D015641:Radiography, Interventional; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media
keywords: Comparative study; computed tomography (CT); emergency departments; fractures; pelvic bones