الفهرس 
Anatomy of thoraxOnly 14 pages are availabe for public view
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Abstract
Thoracic injury is considered the third common cause of trauma
with high morbidity and mortality rates, accounting for 25% of
trauma-related deaths, the blunt injuries forming a majority of thoracic
injuries. Chest radiography was and still the traditional screening tool
in emergency workup, however, the superiority of CT had been
tracked with the significant injuries detected in patients with normal
initial radiographs, or more extensive injuries in abnormal radiographs
which necessitate change of the management plan.
The aim of our study was to illustrate the role of MDCT
capabilities in demonstration of blunt chest trauma.
This study included 40 hemodynamically stable patients;
referred from Emergency department with blunt chest trauma,
presented mainly with chest pain, dyspnea. All were subjected to
clinical history, general and local examination, pelvi-abdominal US,
CXR and MDCT studies for diagnostic evaluation, and received
intravenous water soluble contrast.
The most common mechanism was the motor vehicle related
accidents, and most common injuries were pleural and parenchymal
injuries with more than one injury were found in the same patient.
In this study MDCT was similar to CXR in detecting some
injuries like clavicular fractures and diaphragmatic ruptures, but
higher in detecting injuries, either missed on CXR like sternal, dorsal
spinal fractures, lung herniation, tracheobronchial injuries, small
pneumothoraces or injuries underestimated on CXR as rib fractures,
mediastinal injuries, amount of pleural collections or detailing injuries such as parenchymal, pericardial injuries, and nature of pleural
collections. It also helped in accurate evaluation of inserted chest
tubes, clarified vascular and vascular related injuries, and detecting
upper abdominal injuries, by the nature of using contrast in CT of
trauma patients.
Our results support that MDCT is the imaging modality of
choice for blunt thoracic trauma in hemodynamically stable patients,
being more sensitive and accurate, rapid. MDCT showed superior
sensitivity compared to CXR, detecting injuries totally missed on
CXR with CXR value for other injuries was low compared to MDCT
in term of less numbers detected , underestimated other injuries, and
fewer details which would affect patient care.
MDCT capabilities such as MPR helped in confirming axial
findings, while 3D reconstruction was helpful for bony injuries, and
external VR images were helpful in evaluation of lung volume and
tracheobronchial integrity, the net result were more findings and
precise details that had impact on patients‘ management plans and had
changed many of them.