CT in Blunt Chest Trauma: Indications and Limitations

Milton L. Van Hise, Steven L. Primack, R. Scott Israel, Nestor L. Müller

Research output: Contribution to journalArticle

42 Scopus citations

Abstract

Computed tomography (CT) is the imaging modality of choice in the assessment of patients with clinical or radiographic findings suggestive of aortic injury, bone fracture, or diaphragmatic tear following blunt chest trauma. Contrast material-enhanced spiral CT allows detection of both subtle and more obvious aortic tears. CT has overall greater sensitivity than radiography in the detection of pulmonary lacerations and pneumothoraces. CT may be indicated in cases of suspected tracheobronchial injury. CT is of limited use in the assessment of rib fractures because such injuries are of limited clinical significance and can usually be identified at radiography; however, CT provides optimal visualization of thoracic spine fractures and superior assessment of suspected sternal fractures or sternoclavicular dislocation. Targeted spiral CT with sagittal and coronal reformatted images has increased sensitivity and specificity over that provided by conventional axial CT in the detection of diaphragmatic injury. Optimal CT assessment requires careful attention to technique, including the use of intravenously administered contrast material and multiplanar reconstructed images, as well as an awareness of potential pitfalls. Although in many cases diagnosis can be made with confidence on the basis of CT findings, further investigation is often needed to confirm the diagnosis.

Original languageEnglish (US)
Pages (from-to)1071-1084
Number of pages14
JournalRadiographics
Volume18
Issue number5
DOIs
StatePublished - Jan 1 1998

Keywords

  • Aorta, injuries, 943.412, 943.413
  • Diaphragm, injuries, 66.412, 795.41
  • Lung, injuries, 60.412
  • Mediastinum, hemorrhage, 67.4128
  • Thorax, CT, 60.1211
  • Thorax, injuries, 32.41, 471.41, 472.41, 60.412, 66.412, 943.412, 943.413

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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