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abdomen
abdomen
spleen and liver laceration
spleen and liver laceration
Appears as
non homogenous tissue in the portal venous phase only (the spleen appears non homogenous in arterial phase )
linear or branching hypo densities
subcapsular hematomas
high density material within spleen and liver may indicate active bleeding. can be confirmed if size of high density material increases on delayed imaging
(4) (5)
May require delayed imaging (3-5 minutes delay) to assess active bleeding
Below: splenic laceration shown by non homogenous spleen with shattered appearence in PV phase (1)
Above: Liver laceration shown by linear hypodensies (2)
Below: Liver laceration with high density material within liver may indicate active bleeding. (2)
kidney trauma
kidney trauma
Useful to see if extent of injury has impacted the collecting system of the kidney. This means if an injury is seen we may require an IVP phase of imaging post scan. This occurs around 10 minutes post contrast where the IV contrast will move into the urinary system and fill the ureters.
Left: Kidney and splenic injury in PV phase
Right: Kidney and splenic injury in IVP phase (contrast in right kidney ureter but not seen in left side)
pelvis
pelvis
open book fractures
open book fractures
Open book pelvic injuries result from an anteroposterior compression injury to the pelvis. Open book pelvic injuries are most often the result of high-energy trauma and are associated with significant morbidity and mortality due to associated vascular injuries. For this reason we often perform CTA imaging of the pelvis in cases of open book pelvic injuries (5)
head
head
skull fractures
skull fractures
Fractures and sutures can appear similar as gaps in the bone in te skull. The big difference is that sutures are symmetrical on both sides. In areas where breaks in the bone appear only on one side it is likely a fracture.
Skull fractures are often best demonstrated in 3D VRT's
(see case below from radiopedia) (4)
neck
neck
c-spine fractures
c-spine fractures
Often best appreciated on sagittal views. See case examples from radiopedia below. When C-spine bony injuries are observed CTA neck may be needed to asses the impact fracture may be having on vessels.
Spinous Process Fractures of C7-T2 (3)
Burst fracture of C5 with retroprolusion of bony fragments into spinal canal (3)
Burst fracture of C1 (3)
References
References
https://radiopaedia.org/articles/open-book-pelvic-injury
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