POSTER SECTIONS Coverpage Learning objectives Background Findings and procedure details Conclusion Personal information References

ECR 2018 / C-2876

Imaging of penetrating injuries: Tips and tricks

Congress:

ECR 2018

Poster Number:

C-2876

Type:

Educational Exhibit

Keywords:

Computer Applications-3D, Contrast agent-intravenous, CT-Angiography, CT, Vascular, Trauma, Emergency, Haemorrhage, Education and training

Authors:

M. Naik¹, A. Shekkeris¹, J. Ekpe¹, M. Khan¹, R. Johnson², E. Kashef¹, E. A. Dick¹; ¹London/UK, ²Oxford/UK

DOI:

10.1594/ecr2018/C-2876

DOI-Link:

https://dx.doi.org/10.1594/ecr2018/C-2876

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Learning objectives

1. Review important considerations when interpreting CT studies in penetrating trauma. 2. Develop a systematic approach to image analysis for rapid and accurate reporting.

Background

Penetrating injuries are a significant cause of morbidity and mortality, with a rising incidence in London [1]. Multi-detector CT is widely used to evaluate penetrating injuries in stable patients. Whilst there can be variability in practice and protocolling, the approach to reviewing CT studies remains generally the same. This educational exhibit describes ways to improve the detection of such injuries.

Findings and procedure details

Considerations in reviewing CT imaging following penetrating trauma include: Identifying the main site of injury and depth of the wound Identifying solid organ injury Recognising vascular injury Review areas Identifying the main site of injury and depth of the wound Use of 3D reconstructions and multiplanar reformats is essential to improve diagnostic yield (Figure 1 and 2). Evaluating subcutaneous and intramuscular emphysema can be further clarified using lung and soft tissue windows (Figure 3). Location of haematoma and free fluid can assist in identifying the...

Conclusion

Penetrating injuries can be life-threatening, making prompt diagnosis essential. Recognising key abnormalities on CT ensures patients are triaged appropriately.

Personal information

Dr Mitesh Naik, Radiology Specialist Trainee, Imperial College Healthcare NHS Trust, London, UK Dr Andreas Shekkeris, Consultant Radiologist, Imperial College Healthcare NHS Trust, London, UK Dr Jadesola Ekpe, Radiology Specialist Trainee, Imperial College Healthcare NHS Trust, London, UK Mr Mansoor Khan, Consultant Trauma Surgeon, Imperial College Healthcare NHS Trust, London, UK Dr Rowena Johnson, Consultant Radiologist, Oxford University Hospitals NHS Trust, Oxford, UK Dr Elika Kashef, Consultant Radiologist, Imperial College Healthcare NHS Trust, London, UK Dr Elizabeth Dick, Consultant Radiologist, Imperial College Healthcare NHS Trust,...

References

1. Whittaker G, Norton J, Densley J, Bew D. Epidemiology of penetrating injuries in the United Kingdom: A systematic review. Int J Surg. 2017; 41:65-69. 2. Wani ML, Ahangar AG, Ganie FA, Wani SN, Wani N. Vascular Injuries: Trends in Management. Trauma Mon. 2012; 17(2):266-269. 3. Laing C, Tobias T, Rosenblum D, Banker W, Tseng L, Tamarkin S. Acute Gastrointestinal Bleeding. Emerging Role of Multidetercor CT Angiography and Review of Current Imaging Techniques. Radiographics. 2007; 27:1055-1070. 4. Royal College of Radiologists. Standards of practice and...