Evaluation of a single-pass continuous whole-body 16-MDCT protocol for patients with polytrauma

The purpose of this study was to compare a conventional multiregional MDCT protocol with two continuous single-pass whole-body MDCT protocols in imaging of patients with polytrauma.

Ninety patients with polytrauma underwent whole-body 16-MDCT with a conventional (n=30) or one of two single-pass (n=60) protocols. The conventional protocol included unenhanced scans of the head and cervical spine and contrast-enhanced helical scans (140 mL, 4 mL/s, 300 mg I/mL) of the thorax and abdomen. The single-pass protocols consisted of unenhanced scans of the head followed by one-sweep acquisition from the circle of Willis through the pubic symphysis with a biphasic (150 mL, 6 and 4 mL/s, 300 mg I/mL) or monophasic (110 mL, 4 mL/s, 400 mg I/mL) injection. Acquisition times and interval delays between head, chest, and abdominal scans were recorded. Contrast enhancement was measured in the aortic arch, liver, spleen, and kidney. Diagnostic image quality in the same areas was assessed on a 4-point scale.

Median acquisition times for the single-pass protocols were significantly shorter (-42.5%) than the acquisition time for the conventional protocol. No significant differences were found in mean enhancement values in the aorta, liver, spleen, and kidney for the three protocols. The image quality with both single-pass protocols was better than that with the conventional protocol in assessment of the mediastinum and cervical spine (p<0.05). There was no significant difference between the single-pass protocols.

Use of single-pass continuous whole-body MDCT protocols can significantly decrease examination time for patients with polytrauma and improve image quality compared with a conventional serial scan protocol. Monophasic injection with highly concentrated contrast medium can reduce injection flow rate and should therefore be preferred to a biphasic injection technique.