Diagnostischer Zugewinn der 16-Zeilen-Ganzkörper-Spiral-CT bei polytraumatisierten Patienten differenziert nach Körperregion und Verletzungsschwere gemäß ATLS©-Konzept

PURPOSE: To determine the added diagnostic benefit of using MS-CT in multiple trauma patients differentiated by severity of injury and affected body region. MATERIALS AND METHODS: A retrospective analysis was performed of the 16-row whole-body spiral CT findings in 275 multiple trauma patients (73 % men, 27 % women; age 39.6 ± 18.9 years) with regard to additional findings and new findings obtained with CT compared to the findings obtained by conventional projection radiography and abdominal ultrasound in the emergency room. The additional and new findings were differentiated by body region (head, face, chest, pelvis, abdomen, spine) and the degree of severity according to the three classes of injuries distinguished by the ATLS© concept (class 1: simple injury, class 2: potentially life threatening, class 3: immediately life threatening). RESULTS: A total of 921 additional findings (= findings potentially relevant for further diagnosis and therapy in addition to the findings obtained by conventional radiography or ultrasound) were obtained by MS-CT in all patients. The distribution by number of patients and body region was as follows: 22 neck, 76 face, 125 chest, 112 abdomen, 50 pelvis, and 91 spine. Most additional findings were categorized as potentially life threatening (ATLS class 2). In addition, there were 439 completely new findings, involving the head in 128 patients (mostly ATLS class 3), the face in 18, the chest in 47, the abdomen in 26, and the spine in 9 patients. Most new findings involving the face, abdomen, and spine were ATLS class 2 injuries. CONCLUSION: Compared with conventional radiography and ultrasound in the emergency room, 16-row whole-body spiral CT yields numerous additional and new findings in different body regions in patients with multiple traumas. New findings primarily involved the head, and the additional findings involved the chest, pelvis, and spine. Most findings obtained with CT were potentially life threatening (ATLS class 2).