The role of multislice multidetector CT (MDCT) in abdominal trauma

Purpose: To analyze the role of multidetector CT (MDCT) in the management of abdominal high-energy trauma patients using CT classification of organ injury. Materials and Methods: During the past 2 years, 451 patients with abdominal trauma were examined by MSCT. Most were victims of RTA, 400 men and 51 women, between 18 and 80 years old (mean age 38 years). In 78 patients injury to abdominal organs was diagnosed by MDCT. MDCT (GE Light Speed) was performed using 2.5 mm collimation and 7.5 mm table movement with dynamic IV injection of iohexol 350 mg iodine/ml. A workstation was used for 2D and 3D reconstructions. Results: We detected 24 patients with liver rupture. The spleen was ruptured in 20 cases, kidneys in 14 cases; urinary bladder rupture occurred in 4 cases and urethral rupture in 1 case. In 19 patients, more than one organ injuries were observed. In only 23 patients (30% of all injured with grades 3-4), surgery was an imperative treatment, but the majority of victims with abdominal injuries, grades 1-2, were treated conservatively. Conclusions: MDCT plays a crucial role in the management of patients with abdominal trauma. A team approach (traumatologist, surgeon and radiologist) is mandatory in high-energy trauma.