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Use of 3D imaging in CT of the acute trauma patient: impact of a PACS-based software package

Abstract

To evaluate the impact of a picture archiving and communication systems (PACS)–based software package on the requests for 3D reconstructions of multidetector CT (MDCT) data sets in the emergency radiology of a level 1 trauma center, we reviewed the number and type of physician requests for 3D reconstructions of MDCT data sets for patients admitted after sustaining multiple trauma, during a 12-month period (January 2003–December 2003). During the first 5 months of the study, 3D reconstructions were performed in dedicated workstations located separately from the emergency radiology CT interpretation area. During the last 7 months of the study, reconstructions were performed online by the attending radiologist or resident on duty, using a software package directly incorporated into the PACS workstations. The mean monthly number of 3D reconstructions requested during the two time periods was compared using Student’s t test. The monthly mean ± SD of 3D reconstructions performed before and after 3D software incorporation into the PACS was 34±7 (95% CI, 10–58) and 132±31 (95% CI, 111–153), respectively. This difference was statistically significant (p<0.0001). In the multiple trauma patient, implementation of PACS-integrated software increases utilization of 3D reconstructions of MDCT data sets.

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References

  1. Wintermark M, Mouhsine E, Theumann N et al (2003) Thoracolumbar spine fractures in patients who have sustained severe trauma: depiction with multi-detector row CT. Radiology 227:681–689

    PubMed  Google Scholar 

  2. Sheridan R, Peralta R, Rhea J, Ptak T, Novelline R (2003) Reformatted visceral protocol helical computed tomographic scanning allows conventional radiographs of the thoracic and lumbar spine to be eliminated in the evaluation of blunt trauma patients. J Trauma 55:665–669

    PubMed  Google Scholar 

  3. Hauser CJ, Visvikis G, Hinrichs C, Eber CD et al (2003) Prospective validation of computed tomographic screening of the thoracolumbar spine in trauma. J Trauma 55:234–235

    Google Scholar 

  4. Berne JD, Velmahos GC, El-Tawil Q et al (2000) Value of complete cervical helical computed tomographic scanning in identifying cervical spine injury in the unevaluable blunt trauma patient with multiple injuries: a prospective study. J Trauma 47:896–902

    Google Scholar 

  5. Borrelli J Jr, Goldfarb C, Catalano L, Evanoff BA (2002) Assessment of articular fragment displacement in acetabular fractures: a comparison of computerized tomography and plain radiographs. J Orthop Trauma 16:449–456

    Article  PubMed  Google Scholar 

  6. Kickuth R, Laufer U, Hartung G, Gruening C, Stueckle C, Kirchner J (2002) 3D CT versus axial helical CT versus conventional tomography in the classification of acetabular fractures: a ROC analysis. Clin Radiol 57:140–145

    Article  PubMed  Google Scholar 

  7. Haveri M, Junila J, Suramo I, Lahde S (1988) Multiplanar and 3D CT of acetabular fractures. Acta Radiol 39:257–264

    Google Scholar 

  8. Potok PS, Hopper KD, Umlauf MJ (1995) Fractures of the acetabulum: imaging, classification, and understanding. RadioGraphics 15:7–23

    CAS  PubMed  Google Scholar 

  9. Buitrago-Tellez CH, Schilli W, Bohnert M, Alt K, Kimmig M (2002) A comprehensive classification of craniofacial fractures: postmortem and clinical studies with two- and three-dimensional computed tomography. Injury 33:651–668

    Article  PubMed  Google Scholar 

  10. Liow RY, Birdsall PD, Mucci B, Greiss ME (1999) Spiral computed tomography with two- and three-dimensional reconstruction in the management of tibial plateau fractures. Orthopedics 22:929–932

    CAS  PubMed  Google Scholar 

  11. Jurik AG, Albrechtsen J (1994) The use of computed tomography with two- and three-dimensional reconstructions in the diagnosis of three- and four-part fractures of the proximal humerus. Clin Radiol 49:800–804

    CAS  PubMed  Google Scholar 

  12. Pretorius ES, Fishman EK (1999) Volume-rendered three-dimensional spiral CT: musculoskeletal applications. RadioGraphics 19:1143–1160

    CAS  PubMed  Google Scholar 

  13. Soto JA, Munera F, Morales C et al (2001) Focal arterial injuries of the proximal extremities: helical CT arteriography as the initial method of diagnosis. Radiology 218:188–194

    CAS  PubMed  Google Scholar 

  14. Munera F, Soto JA, Palacio DM et al (2002) Penetrating neck injuries: helical CT angiography for initial evaluation. Radiology 224:366–372

    PubMed  Google Scholar 

  15. Gavant ML, Flick P, Menke P, Gold RE (1996) CT aortography of thoracic aortic rupture. AJR 166:955–961

    CAS  PubMed  Google Scholar 

  16. Parker MS, Matheson TL, Rao AV et al (2001) Making the transition: the role of helical CT in the evaluation of potentially acute thoracic aortic injuries. AJR 176:1267–1272

    CAS  PubMed  Google Scholar 

  17. Killeen KL, Mirvis SE, Shanmuganathan K (1999) Helical CT of diaphragmatic rupture caused by blunt trauma. AJR 173:1611–1616

    CAS  PubMed  Google Scholar 

  18. Michel LA, Lacrosse M, Decanniere L, Rosiere A, Vandenbossche P, Trigaux JP (1997) Spiral computed tomography with three-dimensional reconstructions for severe blunt abdominal traumas: a useful complementary tool? Eur J Emerg Med 4:87–93

    CAS  PubMed  Google Scholar 

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Correspondence to Jorge A. Soto.

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Soto, J.A., Lucey, B.C., Stuhlfaut, J.W. et al. Use of 3D imaging in CT of the acute trauma patient: impact of a PACS-based software package. Emerg Radiol 11, 173–176 (2005). https://doi.org/10.1007/s10140-004-0384-x

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  • DOI: https://doi.org/10.1007/s10140-004-0384-x

Keywords

  • Multidetector row CT
  • PACS
  • Three-dimensional CT
  • Trauma