FEATURE TRAUMA RADIOLOGY
associated with an impact injury that fracture the skull, commonly seen at temporal bone and can associated with temporal lobe herniation, seen as biconvex hyper- attenuating extra-axial lesion. Subdural haematoma (SDH): seen as crescentic extra-axial hyper-attenuating lesion using subdural window (centre 60 Hu, width 120 Hu), coronal reconstruction is very useful. Contusion: Abnormal increased attenuation Diffuse axonal injury: Best seen by MRI especially with FLAIR and T2WIs
CERVICAL SPINE MDCT has far greater sensitivity than radiograph for spine fractures and has been established as the diagnostic standard for spine imaging in blunt trauma for any patient in whom spinal imaging of any kind is mandated by history and physical findings.
«Radiologists involved in trauma care should be familiar with the principles of grading injuries to the different visceral organs»
CHEST Pulmonary contusion: Blood filling the alveolar and interstitial spaces without frank parenchymal disruption. CT appearance can vary from area of ground glass to frank non-enhancing consolidation. It reaches full extend by 12 hours and resolve by 1-2 weeks Laceration: Parenchymal disruption result in a hole within it seen in CT as a round or oval cavity filled with air(traumatic pneumatocele) or blood (haematocele) or both (traumatic hamato-pneumatocele). In post-traumatic setting, pneumothorax and hemothorax, which represent the most frequent primery encountered abnormalities. CT has become the gold standard for detection.
ABDOMEN Sonography: “(FAST) protocol” includes four regions namely, the right upper quadrant with particular attention to the hepato-renal fossa (Morrison’s pouch), the left upper quadrant (subphrenic space and spleno-renal recess), the pelvis with
FIG 1a, 1b, 2a, 2b 3, 4, 5a, 5b ,6 1a 3
1A 4 1b
5a
2a 5b
2b 6
FIG 1 Negative x-ray study for CT proven C1 fracture FIG 2 Bilateral pulmonary contusions (a), bilateral pneumothorax (b) FIG 3 Splenic injury (arrow), failure of contrast uptake of the right kidney secondary to vascular pedicle injury FIG 4 Hepatic injury, grade III FIG 5 a) Combined splenic (dashed arrow) and b) pancreatic tail (solid arrow) injuries FIG 6 Proximal pancreatic transaction (arrow)
Arab Health Issue 5 2011 63
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