Abstract
BackgroundThe aim of this study is to evaluate additional findings which can be detected by post-contrast computed tomography (CCT) in relation to plain CT (PCT) findings in patients presented with head trauma. Medical records of canine patients with the history of head trauma from three institutions were reviewed. PCT- and CCT-anonymized images were evaluated by a veterinary radiologist separately. From the categorized findings the following conclusions were drawn as: abnormalities were identified on (A) PCT but missed on CCT, (B) CCT but missed on PCT, (C) both PCT and CCT.ResultsThirty-two patients were included. The results showed that findings identified on CCT or PCT (category A and B) but missed on the other series were limited to mild soft tissue and sinus changes. Overall, 61 different fracture areas, 6 injuries of the temporomandibular joint (TMJ), 4 orbital injuries, 14 nasal cavities with soft tissue density filling, 13 areas of emphysema, 4 symphysis separations, 12 intracranial hemorrhages, 6 cerebral edema, 5 cerebral midline shifts, 3 intracranial aeroceles, 3 brain herniations and 6 intraparenchymal foreign bodies (defined as an abnormal structure located within the brain: e.g. bony fragments, bullet, teeth,..) were identified on both PCT and CCT separately (category C). Severity grading was different in 50% (3/6) of the reported cerebral edema using PCT and CCT images.ConclusionThe results showed that PCT is valuable to identify the presence of intracranial traumatic injuries and CCT is not always essential to evaluate vital traumatic changes.
Highlights
The aim of this study is to evaluate additional findings which can be detected by post-contrast computed tomography (CCT) in relation to plain Computed tomography (CT) (PCT) findings in patients presented with head trauma
As obtaining post contrast images require additional exposure to ionising radiation and have a small risk of reaction to the contrast medium, this study has been conducted to evaluate the additional findings that can be detected by post-contrast computed tomography (CCT) in addition to plain CT (PCT) findings in dogs presented with head trauma
We hypothesized that PCT would be sufficient to detect the major traumatic changes which may need intervention or management such as intracranial changes and fractures, and demonstrate that CCT is not necessary in patients presenting with head trauma
Summary
The aim of this study is to evaluate additional findings which can be detected by post-contrast computed tomography (CCT) in relation to plain CT (PCT) findings in patients presented with head trauma. Advance imaging offers a selective imaging approach to answer a specific clinical question In this way, the selection of diagnostic imaging modality should be made based on the modality’s ability to demonstrate potential clinically important traumatic pathologies, its repeatability, costs and radiation exposure. As obtaining post contrast images require additional exposure to ionising radiation and have a small risk of reaction to the contrast medium, this study has been conducted to evaluate the additional findings that can be detected by post-contrast computed tomography (CCT) in addition to plain CT (PCT) findings in dogs presented with head trauma. We hypothesized that PCT would be sufficient to detect the major traumatic changes which may need intervention or management such as intracranial changes and fractures, and demonstrate that CCT is not necessary in patients presenting with head trauma
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