Role of multidetector computed tomography imaging in the management of patients with blunt chest trauma

Abstract

Objectives To demonstrate the capabilities of multidetector computed tomography (MDCT), in revealing injuries and guiding management of patients with blunt chest trauma. Background MDCT has become a cornerstone tool for evaluating blunt chest trauma owing to quick scanning, identification of concealed injuries, viewing images in many planes, providing three-dimensional images, ability to clarify tracheobronchial or vascular injuries, usage of contrast media, and detection of coexisting nonthoracic injuries. Patients and methods This study included 40 patients referred from Emergency Department with blunt chest trauma presented mainly with chest pain and dyspnea. All were subjected to clinical history, general and local examination, chest radiography (CXR), and MDCT studies for diagnostic evaluation and received intravenous water-soluble contrast. Results MDCT showed superior sensitivity, detecting more injuries than CXR and detecting other injuries that were totally missed such as sternal, dorsal spinal fractures, lung lacerations, herniation, and trachea-bronchial injuries. CXR sensitivity was low regarding detection of many injuries such as chest wall, pleural, parenchymal, and mediastinal injuries. Accuracy of MDCT was superior to CXR for positive findings providing more details about them with subsequent changes in the management plans. Conclusion Our results support that MDCT is the imaging modality of choice for blunt thoracic trauma in hemodynamically stable patients, being more sensitive and accurate, being rapid, showing injuries that are well clarified with contrast media, and enabling postprocessing reformatted images with subsequent more diagnostic findings that would change patient management plan.