Abstract
PurposeWhole-body computed tomography (WBCT) is the standard diagnostic method for evaluating polytrauma patients. When patients are unable to elevate their arms, the arms are placed along the body, which affects the image quality negatively. Aim of this systematic review is to evaluate the influence of below the shoulder arm positions on image quality of WBCT.MethodsLiterature in PubMed and Scopus databases was systematically searched. Results of the papers were stratified into 4 categories: arms elevated, 1 arm up 1 arm down, arms ventrally supported, arms along the body. A qualitative analysis was performed on subjective image quality and a quantitative analysis on objective quality (image noise).ResultsEight studies were included with 1421 participants. Various studies reported significantly higher quality scores with arms elevated, compared to arms along the body. Significant differences in objective image quality were found between the arms elevated and the arms ventrally on support group. The arms ventrally supported group had a significantly higher image quality than the arms along the body group. A statistically significant difference was found in objective image quality between the 1 arm up 1 arm down and arms along the body group. No preferential below the shoulders position could be identified.ConclusionPositioning the arms alongside the body results in a poor image quality. Placing the arms on a pillow ventrally to the chest improves image quality. Interestingly, asymmetrical arm positioning has potential to improve the image quality for patients that are unable to elevate the arms.
Highlights
In 2010, trauma caused 5,073,300 deaths worldwide among all ages [1]
A systematic review was performed in order to investigate the influence of arm positions on image quality during the image acquisition in Whole-body computed tomography (WBCT)
Data was collected from the PubMed database, searching with the MeSH keywords ‘Tomography, X-Ray Computed’, ‘Arm’, ‘Whole Body Imaging’, ‘Traumatology’
Summary
In 2010, trauma caused 5,073,300 deaths worldwide among all ages [1]. Among persons from 15 to 19 years of age, trauma is the leading cause of death, and in the Netherlands, 19.1% of all polytrauma patients who were admitted in the hospital died [2, 3]. It is necessary that polytrauma patients receive fast and accurate care. The aim of this systematic review is to evaluate the influence of different (below the shoulder) arm positions on image quality of WBCT for polytrauma patients. Emerg Radiol (2020) 27:141–150 independently assigned by two observers. Doubts or disagreements were resolved through discussion with all four observers. Articles with a score below four stars were excluded
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