Imaging in Abdominal and Spine Trauma

1. CT vs MRI

2. Be able to identify common fractures of the spine on CT

Spine

1. eFAST scanning vs CT

2. Be able to recognize common injuries on CT​

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Abdominal

• Quickest

• Repeatable

• Good for picking up free fluid

eFAST - Ultrasound

• Cannot identify active bleeding

• Pools in the dependent recesses

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• In the context of trauma it suggests injury to an intraperitoneal organ

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• Fluid can be blood, bowel contents or urine

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• Used in both ultrasound and CT interpretation​

• Still quick

• Visualizes all abdominal structures*

• Can identify active bleeding if contrast is used​

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Trauma CT

• Requires patient to be relatively stable

1. ​Anatomical planes - normal anatomy

2. Hounsfield Units

3. Windowing

4. Intravenous contrast​

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• Liver

• Spleen

• Bowel

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• Pancreas

• Kidneys

• Bladder​

• Major vessels​

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• ​Rarely an isolated injury

• Trauma can cause pancreatitis, which may develop over days.

• Amylase and lipase wont be elevated for several hours​

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• Usually associated with blows to the flank

• Often tamponades due to confined retroperitoneal space.​

• Trauma c​an disrupt the renal arteries causing renal infarct

• +/- Haematuria

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• Caused by blunt trauma with a full bladder

• Large volume of free fluid

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• ​Can be diagnosed with a delayed contrast CT

1. Look for free fluid

2. Check the solid organs

3. Look for signs of perforation

4. Check t​he retroperitoneum, including vessels

5. Check the bones*​

Password - anatomy

https://www.postdicom.com?Share=30f1c22e-b948-475d-ad10-9b91a655f756&Lang=0

• Used in patients with traumatic neck pain provided the patient is alert and stable with no neurology

• Lateral view is most useful​

Intrepretation ​System

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1. ​Alignment

2. Bones

3. Cartilage (discs)

4. Disability (sp​inal canal)

Better bone detail

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Quicker scan​

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Less claustrophobic​

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Less contraindications​

Can see the cord

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Can see the discs​

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Can see oedema

Ligaments

Cord injury

Bone bruising​

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​Abdomen

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1. Look for free fluid

2. Check the solid organs

3. Look for signs of perforation

4. Check t​he retroperitoneum, including vessels

5. Check the bones*​

Password - anatomy

Spine

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1. ​Alignment

2. Bodies (vertebral)

3. Cartilage (discs)

4. Disability (sp​inal canal)

https://www.postdicom.com?Share=484c7828-6b0d-4319-8657-0b72c620fa57&Lang=0

Password - anatomy

https://www.postdicom.com?Share=6b03ee0d-72b1-4d25-acbb-5e948e1359b1&Lang=0