Ultra-low-dose CT for extremities in an acute setting: initial experience with 203 subjects.

Objective: The purpose of this study was to assess if ultra-low-dose CT is a useful clinical alternative to digital radiographs in the evaluation of acute wrist and ankle fractures.Materials and Methods: An ultra-low-dose protocol was designed on a 256-slice multi-detector CT. Patients from the emer...

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Publicado en:Skeletal Radiology Vol. 49; no. 4; pp. 531 - 540
Autores principales: Alagic, Zlatan, Bujila, Robert, Enocson, Anders, Srivastava, Subhash, Koskinen, Seppo K.
Formato: Journal Article
Publicado: Springer Nature Apr2020
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Apr2020
      vid: 49
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00256-019-03309-7
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        atl: Ultra-low-dose CT for extremities in an acute setting: initial experience with 203 subjects.
      aug:
        au:
          Alagic, Zlatan
          Bujila, Robert
          Enocson, Anders
          Srivastava, Subhash
          Koskinen, Seppo K.
        affil: Functional Unit for Musculoskeletal Radiology Function Imaging and Physiology, Karolinska University Hospital, Karolinska Vägen Solna, 17176, Stockholm, Sweden
      sug:
        subj:
          Wrist Injuries
          Radiation Dosage
          Multidetector Computed Tomography Methods
          Ankle Fractures
          Reproducibility of Results
          Wrist
          Fractures
          Male
          Adolescence
          Ankle
          Female
          Young Adult
          Acute Disease
          Adult
          Aged
          Aged, 80 and Over
          Extremities Injuries
          Middle Age
          Extremities
          Sensitivity and Specificity
          Scales
          Adolescent: 13-18 years
          Adult: 19-44 years
          Aged: 65+ years
          Aged, 80 & over
          Middle Aged: 45-64 years
          Male
          Female
      ab: Objective: The purpose of this study was to assess if ultra-low-dose CT is a useful clinical alternative to digital radiographs in the evaluation of acute wrist and ankle fractures.Materials and Methods: An ultra-low-dose protocol was designed on a 256-slice multi-detector CT. Patients from the emergency department were evaluated prospectively. After initial digital radiographs, an ultra-low-dose CT was performed. Two readers independently analyzed the images. Also, the radiation dose, examination time, and time to preliminary report was compared between digital radiographs and CT.Results: In 207 extremities, digital radiography and ultra-low-dose CT detected 73 and 109 fractures, respectively (p < 0.001). The odds ratio for fracture detection with ultra-low-dose CT vs. digital radiography was 2.0 (95% CI, 1.4-3.0). CT detected additional fracture-related findings in 33 cases (15.9%) and confirmed or ruled out suspected fractures in 19 cases (9.2%). The mean effective dose was comparable between ultra-low-dose CT and digital radiography (0.59 ± 0.33 μSv, 95% CI 0.47-0.59 vs. 0.53 ± 0.43 μSv, 95% CI 0.54-0.64). The mean combined examination time plus time to preliminary report was shorter for ultra-low-dose CT compared to digital radiography (7.6 ± 2.5 min, 95% CI 7.1-8.1 vs. 9.8 ± 4.7 min, 95% CI 8.8-10.7) (p = 0.002). The recommended treatment changed in 34 (16.4%) extremities.Conclusions: Ultra-low-dose CT is a useful alternative to digital radiography for imaging the peripheral skeleton in the acute setting as it detects significantly more fractures and provides additional clinically important information, at a comparable radiation dose. It also provides faster combined examination and reporting times.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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