Spiral computed tomography of upper abdominal trauma

Computed tomography (CT) has long been the imaging study of choice for rapid evaluation of the hemodynamically stable patient with upper abdominal trauma. It has been proven to be both sensitive and specific for the presence and extent of injury to the liver, spleen, and retroperitoneal structures and has made nonoperative management of many posttraumatic patients possible. If CT is obtained in patients with upper abdominal trauma, use of spiral or helical acquisition has important benefits. Spiral CT requires less time for completion of the entire study, which is critical in the traumatized or semi-stable patient. Spiral CT requires less time for data acquisition, as a single spiral of 24-40 seconds may allow evaluation of the entire abdomen. This is particularly important for minimizing motion artifacts in trauma patients, who may have difficulty remaining still or complying with breath-holding. Finally, spiral CT allows scanning at the peak of intravenous contrast enhancement, which is particularly important for evaluation of the liver. We have retrospectively examined CT positive cases of upper abdominal trauma studied by spiral CT and have found it to be an excellent modality in terms of ease of study completion, rapidity of study completion, and ability to make a diagnosis. If CT is to be used for evaluation of upper abdominal trauma, use of spiral acquisition offers several specific and important advantages.