Fellner F A, Krieger J, Lechner N, Flöry D
Zentrales Radiologie Institut, AKH Linz - Kepler Universitätsklinikum/JKU, Krankenhausstr. 9, 4020, Linz, Österreich,
Radiologe. 2014 Sep;54(9):872-9. doi: 10.1007/s00117-013-2635-x.
CLINICAL/METHODICAL ISSUE: Patients with severe, life-threatening trauma require a fast and accurate clinical and imaging diagnostic workup during the first phase of trauma management.
Early whole-body computed tomography has clearly been proven to be the current standard of care of these patients.
A similar imaging quality can be achieved in the multiple trauma setting compared with routine imaging especially using rapid, latest generation computed tomography (CT) scanners.
This article encompasses a detailed view on the use of CT in patients with life-threatening trauma. A special focus is placed on radiological procedures in trauma units and on the methods for CT workup in routine cases and in challenging situations. Another focus discusses the potential of dose reduction of CT scans in multiple trauma as well as the examination of children with severe trauma.
Various studies have demonstrated that early whole-body CT positively correlates with low morbidity and mortality and is clearly superior to the use of other imaging modalities.
Optimal trauma unit management means a close cooperation between trauma surgeons, anesthesiologists and radiologists, whereby the radiologist is responsible for a rapid and accurate radiological workup and the rapid communication of imaging findings. However, even in the trauma setting, aspects of patient radiation doses should be kept in mind.
临床/方法学问题：严重的、危及生命的创伤患者在创伤管理的第一阶段需要快速准确的临床和影像学诊断检查。
早期全身计算机断层扫描已明确被证明是这些患者当前的标准治疗方法。
与常规成像相比，在多发伤情况下使用快速、最新一代计算机断层扫描（CT）扫描仪可获得相似的成像质量。
本文详细介绍了CT在危及生命创伤患者中的应用。特别关注创伤单元中的放射学程序以及常规病例和复杂情况下的CT检查方法。另一个重点讨论了多发伤中CT扫描剂量降低的潜力以及严重创伤儿童的检查。
多项研究表明，早期全身CT与低发病率和死亡率呈正相关，明显优于其他成像方式的使用。
最佳的创伤单元管理意味着创伤外科医生、麻醉师和放射科医生之间密切合作，其中放射科医生负责快速准确的放射学检查以及影像学检查结果的快速沟通。然而，即使在创伤情况下，也应牢记患者辐射剂量的问题。
