Imaging of the brain in polytraumatized patients comparing 64-row spiral CT with incremental (sequential) CT.

Introduction: Up to now, due to a better image quality, for brain imaging the substantially slower sequential examination mode has been preferred during CT in polytraumatized patients. We aimed to re-evaluate modern ultrafast 64-row spiral CT regarding image quality in brain imaging of polytraumatized patients.
Methods: In 30 polytraumatized patients, both 64-row spiral and sequential CT of the brain were performed within 24h. Retrospectively, two radiologists subjectively evaluated the delineation of the internal capsule, the pons, the medial rectus muscle of the orbita, the differentiation of grey/white matter, and the extent of artifacts at the inner skull. Image noise was also evaluated objectively. Statistics were performed using Cohen's kappa and a two-sided t-test.
Results: Perfect or clear agreements were noted regarding the delineation of the inner skull, the medial rectus muscle, the internal capsule, and grey/white matter differentiation. Due to beam hardening artifacts at the level of the pons, no agreement and no superiority of one of the CT-methods was noted. No differences were obtained regarding the objective evaluation of image noise.
Discussion: Image quality is generally equivalent. Since 64-row spiral CT can substantially save examination time we recommend to perform a spiral examination of the brain in polytraumatized patients.
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