16-MDCT can efficiently scan ER patients; repositioning patients may improve image quality

Emergency patients who undergo a 16-MDCT examination spend an average of 15 minutes from the time they enter the room to have the CT examination to the time they leave, a new study shows. The study also found that repositioning the patient adds time to the examination, but may improve image quality.

"In emergency situations, the patient's room time in the CT suite and the early diagnosis and initiation of treatment have an especially profound influence on the patient's outcome," said Jan Gralla, MD, of the department of diagnostic and interventional radiology at the University of Bern in Bern, Switzerland, and lead author of the study.

The study included 497 emergency room patients. In 350 patients, only one body region was scanned. Imaging the neck and cervical spine took an average eight minutes, while CT angiography took 21 minutes. The most time-consuming examination is the multiple trauma patient, with an average room time of 31 minutes, said Dr. Gralla.

Multiple trauma patients usually undergo a whole-body scan, with the patient examined head-first. "This allows fast single-pass scanning, but compromises image quality because of artifacts due to the position of arms, electrodes and cables in the scan field," said Dr. Gralla. "We scanned the patient's head and cervical spine, then turned them and scanned them feet-first. Due to the repositioning procedure, the image quality of multiple trauma cases was comparable to that of routine imaging. Rescanning of certain body regions (due to artifacts, etc.) was not necessary," he said.

Dr. Gralla noted that scanner performance is already of sufficient quality for emergency use; further advances in emergency CT should focus on the development of positioning equipment to maximize the examination, he said.

The study appears in the July 2005 issue of the American Journal of Roentgenology.



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