Title

The value of non-contrast-enhanced CT in blunt abdominal trauma

UMMS Affiliation

Department of Radiology

Publication Date

1-1-1989

Document Type

Article

Subjects

Abdominal Injuries; *Contrast Media; Evaluation Studies; Hematoma; Humans; Prospective Studies; *Tomography, X-Ray Computed; Wounds, Nonpenetrating

Disciplines

Life Sciences | Medicine and Health Sciences

Abstract

The usefulness of non-contrast CT, limited to the upper abdomen, in conjunction with conventional IV contrast-enhanced scanning was studied prospectively in 190 patients who had sustained blunt abdominal trauma. In 78, visceral injuries were confirmed at surgery or at follow-up CT. Of the patients with injuries, 14 (18%) had hyperdense hematomas on the non-contrast studies that became isodense after IV administration of contrast material. These hematomas generally were small and posed an immediate threat to life in only one patient (0.5% of all subjects). In 13% of patients with injury (5% of the total), the additional information did influence treatment planning (surgery in two and intensive conservative treatment in eight). Compared with conventional contrast scanning, the combined non-contrast-contrast technique increased the scanning time only by about 5 1/2 min, but it improved the sensitivity and accuracy of CT in detecting visceral injuries from 74% and 84% to 92% and 91%, respectively (p less than or equal to .003 and p less than or equal to .04). Although contrast-enhanced scanning alone accurately depicts visceral injuries requiring surgical treatment, the incorporation of a non-contrast sequence can detect a subgroup of patients who require intensive conservative management with bed rest and close observation. This additional information can be obtained expeditiously, with minimal additional effort or intervention. The use of non-contrast scanning alone is not recommended.

Rights and Permissions

Citation: AJR Am J Roentgenol. 1989 Jan;152(1):41-8.

DOI of Published Version

10.2214/ajr.152.1.41

Related Resources

Link to article in PubMed

Journal/Book/Conference Title

AJR. American journal of roentgenology

PubMed ID

2783289