Learning objectives
The purpose of our educational exhibit is to:
present the radiological modalities used in the diagnostic work-up of patients with chest trauma stressing the advantages of multidetector computed tomography (MDCT) as a comprehensive technique for the evaluation of these patients;
review the radiographic and CT findings of common and uncommon injuries seen in patients who experienced thoracic trauma;
familiarize the reader with these imaging patterns providing a wide variety of sample images.
Background
Injuries of the thorax are the third most common injuries in trauma patients,
next to injuries of the head and extremities 1.
Furthermore the presence of thoracic injuries in the setting of multisystemic trauma can significantly increase patient mortality.
More than two-thirds of cases of blunt thoracic trauma in developed countries are caused by motor vehicle collisions.
The remaining cases are the result of falls or of blows from blunt object 1.
In addition to this,
there are also penetrating injuries to the chest resulting...
Findings and procedure details
IMAGING TECHNIQUES
Radiography
Once the hemodynamic stability of the patient is assured,
a portable chest radiograph is usually obtained in the emergency room as the initial imaging evaluation.
Upright frontal and lateral chest radiographs are optimal to evaluate chest injuries.
However,
in the polytrauma setting,
supine radiographs are usually performed owing to the need for patient immobilization.
The initial chest radiograph provides information regarding immediately life-threatening conditions,
such as tension pneumothorax or potentially life-threatening conditions,
including hemothorax and pneumothorax.
Other lesions,
such as diaphragm rupture,...
Conclusion
Diagnostic imaging is very important to quickly provide accurate information on the nature and extent of thoracic injuries in traumatized patients.
While the admission chest radiograph is the first look at the traumatized chest,
MDCT serves as the definitive screening study as it adds essential information not readily available on the conventional radiograph.
Moreover,
multiplanar and three-dimensional reconstructions facilitate rapid communication of disease states with surgeons and others involved in the care of injured patients.
Previous statements support MDCT as the best imaging modality for...
Personal information
Gabriele Ironi,
Antonio Esposito,
Roberto Nicoletti,
Francesco De Cobelli,
Carlo Maria Andrea Martinenghi,
Alessandro Del Maschio:
Experimental Imaging Center,
San Raffaele Scientific Institute,
Milan,
Italy
Department of Radiology,
San Raffaele University Hospital,
Milan,
Italy
Roberto Faccincani,
Michele Carlucci:
Department of Emergency,
San Raffaele University Hospital,
Milan,
Italy
Correspondence to:
Gabriele Ironi:
[email protected]
Antonio Esposito:
[email protected]
References
1.
Kaewlai R,
Avery LL,
Asrani AV,
Novelline RA.
Multidetector CT of blunt thoracic trauma.
Radiographics 2008;28:1555-70.
2.
Omert L,
Yeaney WW,
Protetch J.
Efficacy of thoracic computerized tomography in blunt chest trauma.
Am Surg 2001;67:660-4.
3.
Exadaktylos AK,
Sclabas G,
Schmid SW,
Schaller B,
Zimmermann H.
Do we really need routine computed tomographic scanning in the primary evaluation of blunt chest trauma in patients with "normal" chest radiograph? J Trauma 2001;51:1173-6.
4.
Trupka A,
Waydhas C,
Hallfeldt KK,
Nast-Kolb D,
Pfeifer KJ,
Schweiberer L....