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MDCT eliminates need for catheter angiography for injury diagnosis A radiological test used to detect acute coronary trauma saves valuable time and lives in trauma centers, according to MUSC researchers.     The contrast-enhanced 64-multi-detector computed tomography (MDCT) that definitively reveals acute trauma to the aorta does not need confirmation from invasive catheter angiography, according to findings from a new study released by MUSC.   Time is of the essence in evaluating acutely injured patients, and this is especially true in the diagnosis of aortic injuries, said Scott Steenburg, M.D., lead author of the study. “Coming up with a definitive diagnosis of aortic injury takes only minutes with 64-MDCT without the need for mobilizing an angiography team. This allows the trauma and cardiothoracic surgeons to begin treatment almost immediately. For the patient, this means saving precious time as morbidity and mortality increase dramatically for untreated aortic injuries, even with only a few hours of delay,” Steenburg said.   For the study, the authors reviewed during a period of 18 months 581 patients who were imaged for suspicion of aortic injury. Of the 581 patients, 16 were accurately diagnosed with the injury using MDCT, 15 from car collisions, and one from a fall. Of the original 581 patents, a total of 10 catheter angiograms were performed after positive, negative, or equivocal diagnoses on MDCT. The authors discovered that the findings correlated between the two imaging methods in all 10 of those cases.   According to the study authors, MDCT has become the standard for rapid imaging evaluation of trauma patients, and is excellent in general for evaluating the aorta for injuries.   “Since March 2005, practically every trauma patient seen in our trauma center gets some imaging with our 64-MDCT scanner; however, we knew of no study showing the effectiveness of 64-MDCT for aortic injuries,” Steenburg said. “Recently, our surgeons have been taking these patients with evidence of aortic injuries directly to surgery, and we wanted to look back at the data to see how well we were doing with 64-MDCT.”   The results of the study were presented May 7 during the American Roentgen Ray Society Annual Meeting.     Friday, May 25, 2007 Catalyst Online is published weekly, updated as needed and improved from time to time by the MUSC Office of Public Relations for the faculty, employees and students of the Medical University of South Carolina. Catalyst Online editor, Kim Draughn, can be reached at 792-4107 or by email, catalyst@musc.edu. Editorial copy can be submitted to Catalyst Online and to The Catalyst in print by fax, 792-6723, or by email to catalyst@musc.edu. To place an ad in The Catalyst hardcopy, call Island Publications at 849-1778, ext. 201.