Dual-source CT in blunt trauma patients: elimination of diaphragmatic motion using high-pitch spiral technique

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• 作者：Teresa Liang ; Patrick McLaughlin ; Chesnal D. Arepalli ; Luck J. Louis…
• 关键词：Computed tomography (CT) ; Trauma ; Diaphragmatic injury ; Respiratory motion ; Motion artifact
• 刊名：Emergency Radiology
• 出版年：2016
• 出版时间：April 2016
• 年：2016
• 卷：23
• 期：2
• 页码：127-132
• 全文大小：525 KB
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• 作者单位：Teresa Liang (1)
  Patrick McLaughlin (1)
  Chesnal D. Arepalli (1)
  Luck J. Louis (1)
  Ana-Maria Bilawich (1)
  John Mayo (1)
  Savvas Nicolaou (1)
  
  1. Department of Radiology, Vancouver General Hospital, 3350-950 W 10th Avenue, Vancouver, BC, V5Z 1M9, Canada
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Imaging and Radiology
  Emergency Medicine
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1438-1435

文摘

The purpose of this study was to compare diaphragmatic motion on dual-source high-pitch (DS-HP) and conventional single-source (SS) CT scans in trauma patients. Seventy-five consecutive trauma patients who presented to a level one trauma center over a 6-month period were scanned with a standardized whole body trauma CT protocol including both DS-HP chest (pitch = 2.1–2.5) and SS abdominal CT scans. Subjective analysis of diaphragmatic motion was performed by two readers using a four-point motion scale in seven regions of the diaphragm on coronal and axial slices. An overall confidence score to exclude a diaphragmatic tear was determined (1 to 10, 10: completely confident and 1: impossible to exclude). Wilcoxon rank sum tests were used for statistical analysis, and p < 0.05 was considered significant. Mean confidence score of 9.85 for DS-HP was significantly better than the mean score of 7.66 for SS images (p < 0.0001). Diaphragmatic motion scores and subjective diaphragmatic motion artifact on coronal and axial images were significantly better for DS-HP images in all areas when compared individually (p < 0.0001) and overall (p < 0.0001). Regions of DS-HP (99.2 %) were diagnostic, whereas only 87.0 % % regions on SS were. Complete agreement of motion scores was present in 92 % of cases, with moderate overall agreement for confidence to exclude a diaphragmatic tear (κ = 0.45). Dual-source high-pitch CT scanning is advantageous as it allows for significantly better evaluation of diaphragmatic structures by minimizing motion artifacts on images of freely breathing trauma patients.