Contrast-enhanced Computed Tomography Versus Contrast and Non-contrast Enhanced Computed Tomography for Detecting Blunt Abdominal Injury

Abstract

Objective: This study aimed to compare the diagnostic ability of contrast-enhanced computed tomography (CECT) and CECT combined with non-contrast computed tomography (NCT) for intraabdominal organ injury in patients with blunt abdominal injury. Material and Methods: Overall, 195 adult patients having had blunt abdominal trauma underwent CT at this institution; from 2016 and 2021. All CT images were retrospectively reviewed by two radiologists. The efficacy of detection of organ injuries and the degree of intra-abdominal injury were recorded. The radiologists scored their diagnostic confidence for each CT image dataset on a five-point scale: inter-observer agreement was also calculated. Results: All included patients underwent CT for blunt abdominal trauma. The most common cause of injury was motorcycle accident (59.5%), with patients being predominantly male: the mean patient age was 44 years. Hemoperitoneum was the most common CT finding, with a significantly higher detection rate on CECT combined with NCT than on CECT alone. There was no statistically significant difference in the diagnostic efficacy of the detected organ injury nor other types of organ injuries between CECT alone and CECT combined with NCT. Nevertheless, the accuracy of CECT in detecting hemoperitoneum may diminish in patients with severe fatty liver disease; especially in the perihepatic region. Conclusion: CECT alone is a potential tool for detecting abdominal injuries in patients with blunt trauma. NCT provides no additional benefits in detecting organ injury; except in cases of severe fatty liver disease. NCT is recommended as an optional protocol; particularly for patients with obesity.

Keywords

• blunt abdominal trauma
• computed tomography
• contrast-enhanced computed tomography
• non-contrast computed tomography
• radiation exposure