CT QUANTIFICATION OF PLEUROPULMONARY LESI ONS IN SEVERE THORACIC TRAUMA

Purpose: Computed quantification of the extent of pleuropulmonary trau ma by CT and comparison with conventional chest x-ray - Impact on ther apy and correlation with mechanical ventilation support and clinical o utcome. Method: In a prospective trial, 50 patients with clinically su spicious blunt chest trauma were evaluated using CT and conventional c hest x-ray. The computed quantification of ventilated lung provided by CT volumetry was correlated with the consecutive artificial respirati on parameters and the clinical outcome. Results: We found a high corre lation between CT volumetry and artificial ventilation concerning maxi mal pressures and inspiratory oxygen concentration (FiO(2), Goris-Scor e) (r=0.89, Pearson). The graduation of thoracic trauma correlated hig hly with the duration of mechanical ventilation (r=0.98, Pearson). Esp ecially with regard to atelectases and lung contusions CT is superior compared to conventional chest x-ray; only 32% and 43%, respectively, were identified by conventional chest x-ray. Conclusion: CT allows rap id classification and quantification of pulmonary lesions after thorac ic trauma and provides higher sensitivity and reliability. Because of the great correlation with the extent of artificial respiration in res pect of duration and pressure, prognosis of the individual patient, as well as a differential therapy, appear possible.