Triple-split-bolus versus single-bolus CT in abdominal trauma patients: a comparative study

Area of Science:

• Radiology
• Medical Imaging
• Trauma Care

Background:

• Split-bolus computed tomography (CT) is an evolving technique in trauma imaging.
• It involves a single scan of the thorax and abdomen after multiple contrast injections at varied times, unlike traditional multiple scans.
• This contrasts with standard protocols requiring separate scans for different contrast phases.

Purpose of the Study:

• To compare the image quality and diagnostic performance of a novel triple-split-bolus CT (TS-CT) protocol against a standard portal venous phase CT (PV-CT).
• To assess the efficacy of TS-CT in visualizing abdominal organs, major vessels, and the urinary collecting system in trauma patients.

Main Methods:

• A retrospective analysis of trauma patients who underwent both TS-CT and PV-CT between 2009 and 2012.
• TS-CT involved one scan after three contrast boluses (175 mL total) optimized for renal pelvis, abdominal organs, and arterial enhancement.
• Image quality and organ injury findings were assessed, with attenuation measured in Hounsfield units (HU).

Main Results:

• Thirty-five patients were included in the study.
• TS-CT demonstrated significantly higher attenuation values in major abdominal vessels, organs, and the renal pelvis compared to PV-CT.
• Diagnostic performance for organ injury and overall image quality were found to be equivalent between the two protocols.

Conclusions:

• The triple-split-bolus CT (TS-CT) protocol exhibits comparable overall performance to the standard portal venous phase CT (PV-CT) in trauma imaging.
• TS-CT provides excellent visualization of the arterial system and the urinary collecting system.
• This enhanced visualization may obviate the necessity for separate, additional imaging examinations.