Split bolus technique in polytrauma: a prospective study on scan protocols for trauma analysis. (July 2015)

• Record Type: Journal Article
• Authors: Beenen, Ludo FM; Sierink, Joanne C; Kolkman, Saskia; Nio, C Yung; Saltzherr, Teun Peter; Dijkgraaf, Marcel GW; Goslings, J Carel
• Is Part Of: Acta radiologica. Volume 56:Number 7(2015:Jul.)
• Page Start: 873
• Page End: 880
• Publication Date: 2015-07
• Subjects: Adult -- intravenous contrast agents -- computed tomography -- trauma; Radiology, Medical -- Periodicals; Radiography, Medical -- Periodicals; Radiotherapy -- Periodicals; 616.0757
• DOI: 10.1177/0284185114539319
• Languages: English
• ISSNs: 0284-1851

Abstract

Background: For the evaluation of severely injured trauma patients a variety of total body computed tomography (CT) scanning protocols exist. Frequently multiple pass protocols are used. A split bolus contrast protocol can reduce the number of passes through the body, and thereby radiation exposure, in this relatively young and vitally threatened population. Purpose: To evaluate three protocols for single pass total body scanning in 64-slice multidetector CT (MDCT) on optimal image quality. Material and Methods: Three total body CT protocols were prospectively evaluated in three series of 10 consecutive trauma patients. In Group A unenhanced brain and cervical spine CT was followed by chest–abdomen–pelvis CT in portovenous phase after repositioning of the arms. Group B underwent brain CT followed without arm repositioning by a one-volume contrast CT from skull base to the pubic symphysis. Group C was identical to Group A, but the torso was scanned with a split bolus technique. Three radiologists independently evaluated protocol quality scores (5-point Likert scale), parenchymal and vascular enhancement and artifacts. Results: Overall image quality was good (4.10) in Group A, more than satisfactory (3.38) in Group B, and nearly excellent (4.75) in Group C ( P < 0.001). Interfering artifacts were mostly reported in Group B in the liver and spleen. Conclusion: In single pass total body CT scanning a split bolus technique reached the highest overall image quality compared to conventional total body CT and one-volume contrast CT.