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The role of chest computed tomography in trauma

Division of Trauma/Surgical Critical Care University of Southern California, Los Angeles County Hospital, Los Angeles California

P. Rhee

Division of Trauma, Critical Care and Emergency Surgery, The University of Arizona, Tucson, Arizona, USA, prhee{at}surgery.arizona.edu

Chest computed tomography (CCT) evaluation for trauma encompasses two main objectives: (1) The evaluation of the acutely injured in the search for diagnoses and (2) follow up assessment or diagnosis of pulmonary complications in the hospitalised patient. In the acute phase of evaluation, CCT has become particularly helpful for the diagnosis of blunt thoracic aortic injury (BAI), great vessel injury, extent of lung contusion, occult hemothorax, occult pneumothorax, spinal fractures and spinal cord injuries and to determine the tract of transmediastinal gun shot wounds. In the subacute phase, CCT has gained popularity for diagnosing pulmonary embolism and evaluation of retained hemothorax. Technological advances have lead to better diagnostic capabilities that can be obtained quickly but, particularly in the trauma patient, there is little consistent data supporting an outcome improvement in the majority of patients despite changes in clinical management. Further data is needed to support use of CCT in select trauma patient populations to increase useful diagnostic yield and cost effectiveness.

Key Words: Chest trauma • computed tomography • blunt aortic injury • hemothorax • pneumothorax • trauma evaluation • lung contusion • resource management

Trauma, Vol. 10, No. 4, 219-230 (2008)
DOI: 10.1177/1460408608096360


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