The value of precontrast thoraco-abdominopelvic CT in polytrauma patients

• We evaluated the additional value of precontrast CT in polytrauma patient.
• We evaluated the radiation dose CT in polytrauma patient.
• Precontrast CT scan does not have an additional value in polytrauma patient.
• Precontrast CT expose patient to an unjustified radiation dose.

PurposeTo evaluate the utility and radiation dose of thoraco-abdominopelvic precontrast CT in polytrauma patients.Materials and methodsWe examined retrospectively 125 patients who underwent a thoraco-abdominopelvic CT for trauma. Two radiologists, independently, evaluated precontrast CT acquisition and two other radiologists examined the contrast-enhanced scans. A further two radiologists assessed both the acquisitions. Mean value of sensitivity (SE), specificity (SP), positive predictive value (PPV) and negative predictive value (NPV) were calculated by each group of radiologists. For 104 patients, CTDIvol, DLP data and individual mean size were collected to calculate effective dose.ResultsMean values of SE, SP, PPV and NPV of findings of radiologists who assessed contrast-enhanced acquisitions were respectively: SE = 85%, SP = 98%, PPV = 86%, NPV = 88% versus: SE = 43%, SP = 95%, PPV = 69%, NPV = 88% of radiologists who examined non-contrast-enhanced scans. Mean values of radiologists who analyzed both acquisitions were: SE = 80%, SP = 97%, PPV = 80%, NPV = 88%. Neither the precontrast scans nor the precontrast and postcontrast scans together provided additional useful information compared to the single contrast-enhanced acquisition. Patients received a mean dose of 12 mSv for the precontrast CT.ConclusionsPrecontrast CT acquisition did not provide significant information in trauma patients, exposing them to an unjustified radiation dose.