Abstract
Thoracic trauma is the most common injury in polytrauma patients, with an incidence rate of 45–65%, and the most common cause of trauma deaths (about 20 % of all deaths), second only to head injuries.
In the time-sensitive acute care setting, efficiency and rapidity are basic. The Chest-X-Ray (CXR) may be considered as an adjunct to the initial assessment or primary survey of unstable traumatic patients. It helps to identify a tension pneumothorax (PNX) and pleural effusions that may suggest a hemothorax, until further evidence.
MultiSlice Computed Tomography (MSCT) is always the last step of the diagnostic procedures for stable patients, regardless of the positive or negative results on CXR, being the gold standard for the radiologic evaluation of the chest in traumatic patients.
This chapter will review the wide spectrum of radiographic and MSCT findings in patients undergoing a thoracic trauma, both blunt and penetrating, with a particular focus on the role of the radiologist in the management of major trauma, together with the “trauma team”.
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References
Cohn SM (1997) Pulmonary contusion: review of the clinical entity. J Trauma 42:973–979
Gaillard M, Hervé C, Mandin L, Raynaud P (1990) Mortality prognostic factors in chest injury. J Trauma 30:93–96
Ianniello S, Di Giacomo V, Sessa B, Miele V (2014) First-line sonographic diagnosis of pneumothorax in major trauma: accuracy of e-FAST and comparison with multidetector computed tomography. Radiol Med 119: 674–680.
Mayberry JC (2000) Imaging in thoracic trauma: the trauma surgeon’s perspective. J Thorac Imaging 15:76–86
Miele V, Di Giampietro I, Ianniello S, Pinto F, Trinci M (2014) Diagnostic imaging in pediatric polytrauma management. Radiol Med 120:33–49
Peters S, Nicolas V, Heyer CM (2010) Multidetector computed tomography-spectrum of blunt chest wall and lung injuries in polytraumatized patients. Clin Radiol 65:333–338
Rivas LA, Fishman JE, Munera F et al (2003) Multislice CT in thoracic trauma. Radiol Clin North Am 41:599–616
Roy-Choudhury SH, Gallacher DJ, Pilmer J et al (2007) Relative threshold of detection of active arterial bleeding: In vitro comparison of MDCT and digital subtraction angiography. AJR Am J Roentgenol 189:W238–W246
Ryan MF, Hamilton PA, Chu P et al (2004) Active extravasation of arterial contrast agent on post-traumatic abdominal computed tomography. Can Assoc Radiol J 55:160–169
Scaglione M, Pinto A, Pedrosa I et al (2008) Multi-detector row computed tomography and blunt chest trauma. Eur J Radiol 65:377–388
Scott MF, Khodaverdian RA, Shaheen JL et al (2015) Predictors of retained hemothorax after trauma and impact on patient outcomes. Eur J Trauma Emerg Surg. Epub ahead of print
Shanmuganathan K, Mirvis SE (1999) Imaging diagnosis of nonaortic thoracic injury. Radiol Clin North Am 37:533–551
Sivit CJ, Peclet MH, Taylor GA (1989) Life-threatening intraperitoneal bleeding: demonstration with CT. Radiology 71:430
Traub M, Stevenson M, McEvoy S et al (2007) The use of chest computed tomography versus chest X-ray in patients with major blunt trauma. Injury 38:43–47
Trindade LM, Lopes LC, Cipriano GF et al (2009) Alveolar recruitment in pulmonary contusion: case report and literature review. Rev Bras Ter Intens 21:104–108
Ulutas H, Celik MR, Ozgel M et al (2015) Pulmonary pseudocyst secondary to blunt or penetrating chest trauma: clinical course and diagnostic issues. Eur J Trauma Emerg Surg 41:181–188
Van Hise ML, Primack SL, Israel RS et al (1998) CT in blunt chest trauma: indications and limitations. Radiographics 18:1071–1084
Wagner RB, Crawford WO Jr, Schimpf PP (1988) Classification of parenchymal injuries of the lung. Radiology 167:77–82
Wanek S, Mayberry JC (2004) Blunt thoracic trauma: flail chest, pulmonary contusion, and blast injury. Crit Care Clin 20:71–81
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© 2016 Springer International Publishing Switzerland
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Miele, V., Buquicchio, G.L., Piccolo, C.L., Stasolla, A., Galluzzo, M. (2016). Lung Injury. In: Scaglione, M., Linsenmaier, U., Schueller, G., Berger, F., Wirth, S. (eds) Emergency Radiology of the Chest and Cardiovascular System. Medical Radiology(). Springer, Cham. https://doi.org/10.1007/174_2016_51
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DOI: https://doi.org/10.1007/174_2016_51
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