Complementary roles of radionuclide and computed tomographic imaging in evaluating trauma.

For 6 consecutive months all triage acceptable emergency room patients at the St. Francis Medical Center with blunt or penetrating trauma involving the abdomen were included in this review. Computed tomography and radionuclide imaging of the abdomen and urinary tract was performed in addition to the usually indicated diagnostic procedures. In our hospital the Radiology Department is adjacent to the Emergency Department. Close cooperation of the trauma team, the imaging physician and the technologists, has provided a stable, reproducible pattern in the performance and evaluation of nuclear medicine and radiographic techniques. Teleradiologic techniques of image transmission over the telephone lines permits immediate availability of the expertise of the radiologist. This correlation has provided an opportunity for improving patient care and refining our protocol in the care and management of the acutely traumatized patient. One-hundred-twenty-seven patients classed as acute trauma cases were processed during those 6 mo. Forty-two of these patients were not included in this study. They were triaged as immediate surgical emergencies, had incurred injury limited to the head, extremities or thorax, or were not injured sufficiently to require the special care of the designated trauma team. The 85 patients in this study included 56 males and 29 females. The patient age ranged from 3- to 71-yr-of-age. The median age was 29.3 yr. The author feels the findings in this evaluation of the complementary roles of radionuclide imaging and computed tomography should be of value to others in the formulation of their acute trauma care protocol. Nuclear medicine techniques retain an important role in the diagnosis of several sequelae of head trauma. Sensitivity and accuracy for detection of subdural hematoma are not as high as those of transmission computed tomography even if proper techniques are employed. Other important applications, however, include the diagnosis of normal pressure hydrocephalus, location of cerebrospinal fluid leakage, and confirmation of brain death.