Effectiveness of Multislice Computed Tomography in the Detection of Hidden Thoracic Injuries

Background Blunt chest trauma is a serious problem affecting mainly men and it is usually caused by motor car accidents. A chest radiograph is the initial screening modality of trauma patients; however, multislice computed tomography (MSCT) is the modality of choice for rapid assessment of blunt chest trauma patients. Aim The aim was to determine the effectiveness of MSCT over chest radiography in the detection of hidden thoracic injuries in blunt chest trauma patients. Patients and methods The study included 50 patients who presented with blunt chest trauma either as a sole presentation or as a part of polytraumatic insults. All patients underwent chest radiography followed by noncontrast MSCT after a detailed history and complete examination by a cardiothoracic surgeon. Results Pulmonary contusion was the most frequent thoracic injury caused by blunt chest trauma as it occurred in 43 (86%) patients, followed by rib fracture (82%), pleural effusion (72%), pneumothorax (60%), surgical emphysema (50%), and scapular fracture (14%). MSCT was more effective than chest radiography in the detection of thoracic injuries, especially in the pneumothorax and pleural effusion with a percentage of difference was 133 and 120%, respectively, which was highly statistically significant (as P=0.01, 0.03, respectively). Also, it was more effective in the detection of pulmonary contusion, rib fractures, scapular fractures, and surgical emphysema with the percentage of difference being 96.5, 44.7, 14, and 8.3%, respectively. Conclusion MSCT is the imaging modality of choice in evaluating hemodynamically stable blunt chest trauma patients.