Advertisement

Emergency Radiology

, Volume 15, Issue 1, pp 29–34 | Cite as

MDCT of thoraco-abdominal trauma: an evaluation of the success and limitations of primary interpretation using multiplanar reformatted images vs axial images

  • Ashok Jayashankar
  • Unni Udayasankar
  • Sunit Sebastian
  • Eva K. Lee
  • Mannudeep Kalra
  • William SmallEmail author
Original Article

Abstract

To assess whether independent evaluation of coronal and sagittal reformatted images can replace axial images for primary interpretation of multidetector row computed tomography (MDCT) images in patients with thoraco-abdominal trauma. 111 (M/F 69:42) patients with acute chest or abdominal trauma underwent 16-channel MDCT. Coronal and sagittal multiplanar reformatted (MPR) images were generated from thin-section axial images. Two radiologists independently interpreted the MPR images first followed by axial images for both imaging findings as well as adequacy of image quality. Differences between independent reader review of axial and MPR images were assessed using the Wilcoxon signed rank test. There was no significant difference in soft tissue findings identified on MPR vs axial images for either reader, p = 0.91 and 0.34, respectively. However, both readers identified more skeletal findings on the MPR as compared to the axial images, p = 0.026 and 0.040, respectively. There was no significant difference between the readers in their interpretation of axial (soft tissue, p = 0.56; skeletal, p = 0.65) or MPR (soft tissue, p = 0.32; skeletal, p = 0.65) findings. More skeletal findings were identified during the isolated review of MPR as compared to axial images alone. However, the use of MPR images alone still resulted in an unacceptably high number of missed soft tissue and even skeletal findings. A combined approach where both data sets are simultaneously available is therefore preferred.

Keywords

Thoraco-abdominal trauma Multi-planar reformations MPR Coronal Sagittal MDCT 

References

  1. 1.
    Jaffe TA, Nelson RC, Johnson GA et al (2006) Optimization of multiplanar reformations from isotropic data sets acquired with 16-detector row helical CT scanner. Radiology 238:292–299PubMedCrossRefGoogle Scholar
  2. 2.
    Jaffe TA, Martin LC, Miller CM et al (2007) Abdominal pain: coronal reformations from isotropic voxels with 16-section CT—reader lesion detection and interpretation time. Radiology 242:175–181PubMedGoogle Scholar
  3. 3.
    Kwan SW, Partik BL, Zinck SE et al (2005) Primary interpretation of thoracic MDCT images using coronal reformations. Ajr 185:1500–1508PubMedCrossRefGoogle Scholar
  4. 4.
    Jaffe TA, Martin LC, Thomas J, Adamson AR, DeLong DM, Paulson EK (2006) Small-bowel obstruction: coronal reformations from isotropic voxels at 16-section multi-detector row CT. Radiology 238:135–142PubMedCrossRefGoogle Scholar
  5. 5.
    Kozuka T, Tomiyama N, Johkoh T et al (2003) Coronal multiplanar reconstruction view from isotropic voxel data sets obtained with multidetector-row CT: assessment of detection and size of mediastinal and hilar lymph nodes. Radiat Med 21:23–27PubMedGoogle Scholar
  6. 6.
    Lucey BC, Stuhlfaut JW, Hochberg AR, Varghese JC, Soto JA (2005) Evaluation of blunt abdominal trauma using PACS-based 2D and 3D MDCT reformations of the lumbar spine and pelvis. Am J Roentgenol 185:1435–1440CrossRefGoogle Scholar
  7. 7.
    Paulson EK, Harris JP, Jaffe TA, Haugan PA, Nelson RC (2005) Acute appendicitis: added diagnostic value of coronal reformations from isotropic voxels at multi-detector row CT. Radiology 235:879–885PubMedCrossRefGoogle Scholar
  8. 8.
    Rees O, Mirvis SE, Shanmuganathan K (2005) Multidetector-row CT of right hemidiaphragmatic rupture caused by blunt trauma: a review of 12 cases. Clin Radiol 60:1280–1289PubMedCrossRefGoogle Scholar
  9. 9.
    Tsubamoto M, Johkoh T, Kozuka T et al (2003) Coronal multiplanar reconstruction view from whole lung thin-section CT by multidetector-row CT: determination of malignant or benign lesions and differential diagnosis in 68 cases of solitary pulmonary nodule. Radiat Med 21:267–271PubMedGoogle Scholar
  10. 10.
    Begemann PG, Kemper J, Gatzka C, Stork A, Nolte-Ernsting C, Adam G (2004) Value of multiplanar reformations (MPR) in multidetector CT (MDCT) of acute vertebral fractures: do we still have to read the transverse images? J Comput Assist Tomogr 28:572–580PubMedCrossRefGoogle Scholar

Copyright information

© Am Soc Emergency Radiol 2007

Authors and Affiliations

  • Ashok Jayashankar
    • 1
  • Unni Udayasankar
    • 1
  • Sunit Sebastian
    • 1
  • Eva K. Lee
    • 2
  • Mannudeep Kalra
    • 3
  • William Small
    • 1
    Email author
  1. 1.Division of Abdominal Imaging, Department of RadiologyEmory University School of MedicineAtlantaUSA
  2. 2.Center for Operations Research in Medicine, Industrial & Systems EngineeringGeorgia Institute of TechnologyAtlantaUSA
  3. 3.Department of RadiologyMassachusetts General HospitalBostonUSA

Personalised recommendations