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A comparison of the diagnostic performances of visceral organ-targeted versus spine-targeted protocols for the evaluation of spinal fractures using sixteen-channel multidetector row computed tomography: is additional spine-targeted computed tomography necessary to evaluate thoracolumbar spinal fractures in blunt trauma victims?

Authors
 Sungjun Kim  ;  Choon Sik Yoon  ;  Jeong Ah Ryu  ;  Sungah Lee  ;  Ye-Soo Park  ;  Sam Soo Kim  ;  Young Han Lee  ;  Jin-Suck Suh 
Citation
 Journal of Trauma, Vol.69(2) : 437-446, 2010 
Journal Title
 Journal of Trauma 
ISSN
 0022-5282 
Issue Date
2010
MeSH
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Algorithms ; Child ; Cohort Studies ; Female ; Humans ; Lumbar Vertebrae/diagnostic imaging* ; Lumbar Vertebrae/injuries ; Male ; Middle Aged ; ROC Curve ; Reproducibility of Results ; Risk Assessment ; Sensitivity and Specificity ; Spinal Fractures/diagnostic imaging* ; Thoracic Vertebrae/diagnostic imaging* ; Thoracic Vertebrae/injuries ; Tomography, X-Ray Computed/methods* ; Viscera/diagnostic imaging* ; Viscera/injuries* ; Wounds, Nonpenetrating/diagnostic imaging* ; Young Adult
Abstract
BACKGROUND: It remains to be determined whether spine-targeted computed tomography (thoracolumbar spine computed tomography [TLS-CT]) images and visceral organ-targeted CT (abdominopelvic [AP]-CT) images are comparable for the evaluation of thoracolumbar spinal fractures using 16-channel multidetector row CT. The elimination of an additional spine-targeted CT protocol would substantially reduce time, the storage burden, and potential patient radiation exposure. METHODS: A total of 420 vertebrae in 72 consecutive patients who underwent AP-CT to assess blunt traumatic injury and an additional CT examination using a TLS-CT protocol to evaluate spinal fractures were retrospectively evaluated. The AP-CT set (set A, reconstructed with using a wide display field of view [FOV] and a soft algorithm) and the TLS-CT set (set S, reconstructed using a narrow display FOV and a hard algorithm) were composed of axial plus reformatted sagittal or coronal images or both. Three radiologists independently reviewed all CT data retrospectively. Performances for detecting and typing fractures were compared by using areas under receiver operating characteristic curves and by determining concordance rates. RESULTS: The overall areas under the curves for sets S and A for fracture detection were 0.996 and 0.995, respectively; no significant difference was found between the two sets. Concordance rates for typing performance also showed no statistical significance between the two sets for any of the three observers. CONCLUSION: Sixteen-channel multidetector row CT images reconstructed using a soft algorithm and a wide display FOV that cover the entire abdomen using a visceral organ-targeted protocol with 1.5-mm collimation are sufficient for the evaluation of spine fractures in trauma patients, given that multiplanar-reformatted images are provided.
Full Text
http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00005373-201008000-00029&LSLINK=80&D=ovft
DOI
10.1097/TA.0b013e3181e491d8
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Sungjun(김성준) ORCID logo https://orcid.org/0000-0002-7876-7901
Suh, Jin Suck(서진석) ORCID logo https://orcid.org/0000-0001-9455-9240
Yoon, Choon Sik(윤춘식) ORCID logo https://orcid.org/0000-0003-2010-6710
Lee, Young Han(이영한) ORCID logo https://orcid.org/0000-0002-5602-391X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/102672
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