The new protocol is the brainchild of radiographer Salim Bader and Dr. Gal Yaniv, PhD, who combined two previously described trauma protocols to produce a hybrid technique.
The new method improves enhancement of abdominal blood vessels and parenchyma, and eliminates mediastinal streak artifacts, the group told AuntMinnie.com.
The protocol was tested in 100 multitrauma patients beginning in 2010. Half underwent a conventional protocol (unenhanced scans of the head and cervical spine; arterial-phase, contrast-enhanced scan of the thorax; and a portal venous scan of the abdomen and pelvis), while the other half used the new protocol (unenhanced scans of the head and cervical spine, followed by a one-sweep acquisition of the thorax and abdomen after a triphasic injection). Contrast enhancement was measured in multiple regions in the CT data.
Using the new protocol, Bader and colleagues found better enhancement of abdominal blood vessels and parenchyma and elimination of mediastinal streak artifacts.
"In the revised protocol, we see the vessels in two phases, arterial and portal venous, compared to the conventional protocol where we get only the porto-venous phase," Bader said, adding that there are no mediastinal artifacts. In addition, the upper abdomen is scanned only once in the single-pass scan versus twice in the conventional scan.
Reconstruction is much simpler as well, he said. Previously, reconstructions of the chest and abdomen had to be performed separately, whereas they are now generated together. The single-pass scan also delivers a lower radiation dose.
