Gerta Repečkaitė1, Kristina Banionienė1, Eglė Kirklienė1, Jurgita Zaveckienė.1
1Department of Radiology of Lithuanian University of Health Sciences Kaunas, Lithuania.
Background: Traumatic injuries are the fourth most common cause of death in all age/race/sex groups. Computed tomography (CT) is considered to be the current gold standard when providing a quick and accurate diagnosis of multiple injuries. However, a consensus regarding the study of chest – abdomen – pelvis (C-A-P) in polytrauma patients (PP) has not been reached.
Aim: To present an attempt at reducing the dose of ionizing radiation from CT in an emergency setting.
Materials and methods: We reviewed the hospital’s medical records for PP who had undergone CT scans between 2011 and 2016. We evaluated CT phase sensitivity and contribution to the radiation dose and the associated oncogenic risk, as well as the workload of a radiologist.
Results: The most common traumatic findings were blood and/or hematoma within the abdominal cavity, lung contusion, pneumothorax, parenchymal organ injury, and rib fractures. The non-enhanced phase did not supply any additional information and was inferior to contrast-enhanced phases when diagnosing parenchymal organ injury and active hemorrhaging, meanwhile, it contributed to 19.7% of the workload and 29.5% of the radiation. The mean effective doses (ED) of C-A-P CT and whole body CT (WBCT) were 61.2 (± 27.7) mSv and 109.4 (± 30.5) mSv accordingly. PP’ received WBCT related mean ED was associated with cancer morbidity risk of 0.5% or 1/167.
Conclusion: Non-enhanced CT scans in PP contribute to wasted resources, increased radiation doses and higher future cancer risk, and supply no additional data when diagnosing traumatic findings.
Keywords: multiple trauma, radiation dosage, diagnostic imaging