Diagnostic Imaging, Department for Companion Animals and Horses, University of Veterinary Medicine Vienna (Vetmeduni), Veterinärplatz 1, 1210, Vienna, Austria.
Department of Veterinary Medical Imaging and Small Animal Orthopaedics, Ghent University, Ghent, Belgium.
BMC Vet Res. 2021 Jan 22;17(1):46. doi: 10.1186/s12917-021-02764-6.
The aim of this study is to evaluate additional findings which can be detected by post-contrast computed tomography (CCT) in relation to plain CT (PCT) findings in patients presented with head trauma. Medical records of canine patients with the history of head trauma from three institutions were reviewed. PCT- and CCT-anonymized images were evaluated by a veterinary radiologist separately. From the categorized findings the following conclusions were drawn as: abnormalities were identified on (A) PCT but missed on CCT, (B) CCT but missed on PCT, (C) both PCT and CCT.
Thirty-two patients were included. The results showed that findings identified on CCT or PCT (category A and B) but missed on the other series were limited to mild soft tissue and sinus changes. Overall, 61 different fracture areas, 6 injuries of the temporomandibular joint (TMJ), 4 orbital injuries, 14 nasal cavities with soft tissue density filling, 13 areas of emphysema, 4 symphysis separations, 12 intracranial hemorrhages, 6 cerebral edema, 5 cerebral midline shifts, 3 intracranial aeroceles, 3 brain herniations and 6 intraparenchymal foreign bodies (defined as an abnormal structure located within the brain: e.g. bony fragments, bullet, teeth,..) were identified on both PCT and CCT separately (category C). Severity grading was different in 50% (3/6) of the reported cerebral edema using PCT and CCT images.
The results showed that PCT is valuable to identify the presence of intracranial traumatic injuries and CCT is not always essential to evaluate vital traumatic changes.
本研究旨在评估在因头部外伤就诊的患者中，与平扫 CT（PCT）结果相比，增强 CT（CCT）可发现哪些额外的发现。对来自三个机构的具有头部外伤病史的犬科患者的病历进行了回顾。由一名兽医放射科医师分别对 PCT 和 CCT 匿名图像进行评估。根据分类结果得出以下结论：在（A）PCT 上发现但在 CCT 上漏诊、（B）CCT 上发现但在 PCT 上漏诊、（C）PCT 和 CCT 上均发现的异常。
共纳入 32 例患者。结果表明，在 CCT 或 PCT 上发现但在另一系列上漏诊的发现仅限于轻度软组织和窦变化。总体而言，发现了 61 个不同的骨折区域、6 个颞下颌关节（TMJ）损伤、4 个眼眶损伤、14 个鼻道软组织密度填充、13 个气肿区域、4 个联合分离、12 个颅内出血、6 个脑水肿、5 个大脑中线移位、3 个颅内积气、3 个脑疝和 6 个脑实质内异物（定义为异常结构位于脑内：例如骨碎片、子弹、牙齿等）分别在 PCT 和 CCT 上均被发现（C 类）。使用 PCT 和 CCT 图像对 50%（3/6）报告的脑水肿进行严重程度分级时，结果不同。
结果表明，PCT 可用于识别颅内创伤性损伤的存在，而 CCT 并非总是评估重要创伤性变化所必需。
