Time is of the essence in evaluating acutely injured patients, and this is especially true in the diagnosis of aortic injuries, said Scott Steenburg, MD, lead author of the study. “Coming up with a definitive diagnosis of aortic injury takes only minutes with 64-MDCT (Contrast-enhanced 64 Multislice Detector Computed Tomography) without the need for mobilizing an angiography team. This allows the trauma and cardiothoracic surgeons to begin treatment almost immediately,” he said.
For the study, the authors reviewed 581 patients over a period of 18 months who were imaged for suspicion of aortic injury. Of the 581 patients, 16 were accurately diagnosed with the injury using MDCT, 15 from car collisions and one from a fall.
Of the original 581 patients, a total of ten catheter angiograms were performed after positive, negative, or equivocal diagnoses on MDCT. The authors discovered that the findings correlated between the two imaging methods in all ten of those cases.
According to the study authors, MDCT has become the standard for rapid imaging evaluation of trauma patients, and is excellent in general for evaluating the aorta for injuries. MDCT works so well for diagnosing aortic injuries that trauma centers rarely do direct catheter angiograms for aortic injuries anymore, say the study authors.
“The surgical staff is confident in our diagnoses because of the excellent images we are able to generate. We have done a handful of angiograms for difficult or equivocal cases since installing our 64-MDCT scanner, but the same diagnostic uncertainties are apparent in both imaging methods and are open to interpretive subjectivity,” said Steenburg.
COMPAMED.de; Source: American Roentgen Ray Society (ARRS)