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Split bolus technique in polytrauma: a prospective study on scan protocols for trauma analysis.

Ludo F M Beenen1, Joanne C Sierink2, Saskia Kolkman3

  • 1Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands l.f.beenen@amc.uva.nl.

Acta Radiologica (Stockholm, Sweden : 1987)
|July 19, 2014
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A split bolus contrast protocol significantly improves single pass total body computed tomography (CT) scanning for trauma patients. This technique enhances image quality and reduces radiation exposure compared to conventional methods.

Keywords:
Adultcomputed tomographyintravenous contrast agentstrauma

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Area of Science:

  • Radiology
  • Medical Imaging
  • Trauma Care

Background:

  • Multiple computed tomography (CT) scanning protocols exist for evaluating severely injured trauma patients.
  • Conventional protocols often involve multiple passes, increasing radiation exposure.
  • A split bolus contrast protocol offers a potential solution to reduce passes and radiation in this population.

Purpose of the Study:

  • To evaluate three distinct single pass total body scanning protocols using 64-slice multidetector CT (MDCT).
  • The primary objective was to determine the protocol yielding optimal image quality for trauma patients.

Main Methods:

  • Three prospective protocols were tested on consecutive trauma patient groups (n=10 each).
  • Group A: Unenhanced brain/cervical spine CT followed by repositioned-arm portovenous phase chest-abdomen-pelvis CT.
  • Group B: Brain CT followed by one-volume contrast CT (skull base to pubic symphysis) without arm repositioning.
  • Group C: Similar to Group A, but utilized a split bolus technique for torso scanning.

Main Results:

  • Overall image quality scores were: Group A (4.10 - good), Group B (3.38 - satisfactory), and Group C (4.75 - nearly excellent).
  • Group C demonstrated statistically significant superior image quality (P < 0.001).
  • Interfering artifacts were more prevalent in Group B, particularly in the liver and spleen.

Conclusions:

  • Single pass total body CT scanning benefits from a split bolus technique.
  • This method achieved superior overall image quality compared to conventional total body CT and one-volume contrast CT.
  • Split bolus technique is recommended for optimizing trauma CT imaging.