Skip to main content

Advertisement

SpringerLink
Log in

Low-dose MDCT findings of blunt hepatobiliary trauma

  • Pictorial Essay
  • Published:
Emergency Radiology Aims and scope Submit manuscript

Abstract

This pictorial essay shows low-dose multi-detector computed tomography (MDCT) findings of blunt hepatobiliary trauma, and describes the indications and protocol for MDCT. Given the universal usage of MDCT in assessing the liver in blunt abdominal trauma, reduction of patient dose is essential. The new l0se MDCT protocol presented here can achieve up to 50% dose reduction while maintaining diagnostic image quality and thus facilitate dose sensitive patient management. Our institution’s blunt hepatobiliary MDCT imaging algorithm can help determine which patients require operative therapy. Injury to the liver is graded on various schemes, one being the Organ Injury Scale devised by the American Association for the Surgery of Trauma classification based on the extension of the lesion and bleeding.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9
Fig. 10
Fig. 11
Fig. 12
Fig. 13
Fig. 14
Fig. 15
Fig. 16
Fig. 17
Fig. 18
Fig. 19
Fig. 20

Similar content being viewed by others

References

  1. Christe A, Ross S, Oesterhelweg L, Spendlove D, Bolliger S, Vock P, Thali MJ (2009) Abdominal trauma—sensitivity and specificity of postmortem noncontrast imaging findings compared with autopsy findings. J Trauma 66(5):1302–7

    Article  PubMed  Google Scholar 

  2. Matthes G, Stengel D, Seifert J et al (2003) Blunt liver injuries in polytrauma: results from a cohort study with the regular use of whole-body helical computed tomography. World J Surg 27:1124–1130

    Article  PubMed  Google Scholar 

  3. Shuman WP (1997) CT of blunt abdominal trauma in adults. Radiology 205(2):297–306

    PubMed  CAS  Google Scholar 

  4. Beal SL (1990) Fatal hepatic hemorrhage: an unresolved problem in the management of complex liver injuries. J Trauma 30:163–9

    Article  PubMed  CAS  Google Scholar 

  5. Pachter HL, Spencer FC, Hofstetter SR, Liang HG, Coppa GF (1992) Significant trends in the treatment of hepatic trauma: experience with 411 injuries. Ann Surg 215:492–500

    Article  PubMed  CAS  Google Scholar 

  6. Ochsner MG, Knudson MM, Pachter HL et al (2000) Significance of minimal or no intraperitoneal fluid visible on CT scan associated with blunt liver and splenic injuries: a multicenter analysis. J Trauma 49(3):505–10

    Article  PubMed  CAS  Google Scholar 

  7. Romano L, Giovine S, Guidi G, Tortora G, Cinque T, Romano S (2004) Hepatic trauma: CT findings and considerations based on our experience in emergency diagnostic imaging. Eur J Radiol 50:59–66

    Article  PubMed  Google Scholar 

  8. Sampson MA, Colquhoun KBM, Hennessy NLM (2006) Computed tomography whole body imaging in multi-trauma: 7 years experience. Clinical Radiology 61:365–369

    Article  PubMed  CAS  Google Scholar 

  9. Tas F, Ceran C, Atalar MH, Bulut S, Selbes B, Isik AO (2004) The efficacy of ultrasonography in hemodynamically stable children with blunt abdominal trauma: a prospective comparison with computed tomography. Eur J Radiol 51:91–96

    PubMed  Google Scholar 

  10. Shanmuganathan K, Mirvis SE (1995) CT evaluation of the liver with acute blunt trauma. Crit Rev Diagn Imaging 36:73–113

    PubMed  CAS  Google Scholar 

  11. Kinnunen J, Kivioja A, Poussa K, Laasonen EM (1994) Emergency CT in blunt abdominal trauma of multiple injury patients. Acta Radiol 35:319–22

    PubMed  CAS  Google Scholar 

  12. Petridis A, Pilavaki M, Vafiadis E, Palladas P, Finitsis S, Drevelegas A (1999) CT of hemodynamically unstable abdominal trauma. Eur Radiol 9:250–255

    Article  PubMed  CAS  Google Scholar 

  13. Molina DK, Nichols JJ, DiMaio VJ (2007) The sensitivity of computed tomography (CT) scans in detecting trauma: are CT scans reliable enough for courtroom testimony? J Trauma 63:625–629

    Article  PubMed  Google Scholar 

  14. Moore EE, Cogbill TH, Jurkovich GJ, Shackford SR, Malangoni MA, Champion HR (1995) Organ injury scaling: spleen and liver (1994 revision). J Trauma 38(3):323–324

    Article  PubMed  CAS  Google Scholar 

  15. Helling TS, Ward MR, Balon J (2009) Is the grading of liver injuries a useful clinical tool in the initial management of blunt trauma patients? Eur J Trauma Emerg Surg 35:95–101

    Article  Google Scholar 

  16. MacLean A, Durso A, Cohn SM et al (2005) A clinically relevant liver injury grading system by CT, preliminary report. Emerg Radiol 12:34–7

    Article  PubMed  Google Scholar 

  17. Cohn S, Arango J, Myers J et al (2009) Computed tomography grading systems poorly predict the need for intervention after spleen and liver injuries. Am Surg 75(2):133–139

    PubMed  Google Scholar 

  18. Shanmuganathan K, Mirvis SE (1998) CT scan evaluation of blunt hepatic trauma. Radiol Clin North Am 36:399–411

    Article  PubMed  CAS  Google Scholar 

  19. Yoon W, Jeong YY, Kim JK, Seo JJ, Lim HS, Shin SS et al (2005) CT in blunt liver trauma. Radiographics 25:87–104

    Article  PubMed  Google Scholar 

  20. Savolaine ER, Grecos GP, Howard J, White P (1985) Evolution of CT findings in hepatic hematoma. J Comput Assist Tomogr 9:1090–1096

    Article  PubMed  CAS  Google Scholar 

  21. Shanmuganathan K, Mirvis SE, Sover ER (1993) Value of contrast-enhanced CT in detecting active hemorrhage in patients with blunt abdominal or pelvic trauma. AJR Am J Roentgenol 161:65–69

    PubMed  CAS  Google Scholar 

  22. Cogbill TH, Moore EE, Jurkovich GJ et al (1988) Severe hepatic trauma: a multicenter experience with 1,335 liver injuries. J Trauma 28:1433–1438

    Article  PubMed  CAS  Google Scholar 

  23. Knudson MM, Lim RC, Oakes DD et al (1990) Nonoperative management of blunt liver injuries in adults: the need for continued surveillance. J Trauma 30:1494–1500

    Article  PubMed  CAS  Google Scholar 

  24. Goffette PP, Laterre PF (2002) Traumatic injuries: imaging and intervention in post-traumatic complications (delayed intervention). Eur Radiol 12:994–1021

    Article  PubMed  Google Scholar 

  25. Cywes S, Bass DH, Rode H et al (1991) Blunt liver trauma in children. Injury 22:310–314

    Article  PubMed  CAS  Google Scholar 

  26. Eng RH, Tecson-Tumang F, Corrado ML (1981) Blunt trauma and liver abscess. Am J Gastroenterol 76:252–255

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, University of British Columbia, Vancouver, Canada

    Arash Eftekhari, Ahmed Abdulwahab Albuali, Sandro Galea-Soler & Savvas Nicolaou

  2. Faculty of Medicine, Memorial University of Newfoundland, St. John’s, Canada

    Dipinder Keer

Authors
  1. Arash Eftekhari
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ahmed Abdulwahab Albuali
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Dipinder Keer
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sandro Galea-Soler
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Savvas Nicolaou
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ahmed Abdulwahab Albuali.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Eftekhari, A., Albuali, A.A., Keer, D. et al. Low-dose MDCT findings of blunt hepatobiliary trauma. Emerg Radiol 18, 235–247 (2011). https://doi.org/10.1007/s10140-011-0938-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10140-011-0938-7

Keywords

Search

Navigation