Value of multidetector computed tomography in assessing blunt multitrauma patients

PURPOSE: To find out if multidetector computed tomography (MDCT), using a dedicated trauma protocol, provides sufficient diagnostic information of the injuries of blunt multitrauma patients to enable the planning of treatment for all body compartments. MATERIAL AND METHODS: One-hundred-and-thirty-three patients exposed to high-energy trauma were referred and scanned with the standardized MDCT multitrauma protocol. The imaging protocol consisted of axial scanning of the head and helical scanning of the facial bones, cervical spine, thorax, abdomen, and pelvis. The scanning times were 12 s for the head, 19-21 s for the facial bones and cervical spine (1 mm collimation), and 32-50 s for the thorax, abdomen, and pelvis (2 mm collimation). One-hundred-and-forty milliliters of non-iodinated contrast material (300 mg I/ml) was administered intravenously at 3 ml/s. RESULTS: Ninety-nine of the patients (74%) had at least one finding consistent with trauma. The most frequent findings were in the thorax in 58 patients (44%). Nineteen false-negative findings and two false-positive findings were made. The overall sensitivity of MDCT was 94%, specificity 100%, and accuracy 97%. CONCLUSION: MDCT is accurate in the assessment of blunt multitrauma patients. The decision to treat the patient can be made on the basis of MDCT with a reasonable level of certainty.