European Journal of Radiology 65 (2008) 377–388 Multi-detector row computed tomography and blunt chest trauma Mariano Scaglione a,* , Antonio Pinto a , Ivan Pedrosa b , Amelia Sparano a , Luigia Romano a a Emergency and Trauma CT Section, Department of Radiology, Cardarelli Hospital, Via G. Merliani 31, 80127 Napoli, Italy b Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, USA Received 6 September 2007; received in revised form 7 September 2007; accepted 8 September 2007 Abstract Blunt chest trauma is a significant source of morbidity and mortality in industrialized countries. The clinical presentation of trauma patients varies widely from one individual to another and ranges from minor reports of pain to shock. Knowledge of the mechanism of injury, the time of injury, estimates of motor vehicle accident velocity and deceleration, and evidence of associated injury to other systems are all salient features to provide for an adequate assessment of chest trauma. Multi-detector row computed tomography (MDCT) scanning and MDCT-angiography are being used more frequently in the diagnosis of patients with chest trauma. The high sensitivity of MDCT has increased the recognized spectrum of injuries. This new technology can be regarded as an extremely valuable adjunct to physical examination to recognize suspected and unsuspected blunt chest trauma. © 2007 Elsevier Ireland Ltd. All rights reserved. Keywords: Computed tomography; Multi-slice computed tomography; Thoracic trauma; Mechanism of injury 1. Introduction Trauma affects young people and brings about high morbidity and mortality rates at high socio-economic costs [1]. Trauma is responsible for 100,000 deaths annually in the United States [2]. Estimates of thoracic trauma frequency indicate that injuries occur in 12 out of million people every day [2]. Approximately, 33% of these injuries require hospital admission [3,4]. Overall, blunt thoracic injuries are directly responsible for 20–25% of all deaths, and chest trauma is a major contributor in another 50% of deaths [2]. Decisive qualitative improvements have been made in the management of polytraumatized patients by providing surgical and intensive care treatment at Specialized Centres, by imple- menting Emergency Department algorithms and, not least of all, by the advances made in the field diagnostic imaging [5–8]. In an * Corresponding author. Tel.: +39 081 5584821; fax: +39 081 5584821. E-mail address: mscaglione@tiscali.it (M. Scaglione). ergonomic system the management of trauma is of paramount importance, and the entire procedure plan is essential for the patient’s outcome [7–9]. Our increasing knowledge of shock and resuscitation thera- pies as well as the advancements made in diagnostic imaging and surgery techniques have led to a considerable increase in the survival rate [8–10]. The main purpose in trauma care is the maximum concentra- tion of time which has a great impact on the results in terms of resuscitation and safety [11,12]. The use of imaging modalities in the management of polytraumatized patients makes for more reliable and faster identification of injuries, which is crucial for therapeutic decision-making [3]. The aim of diagnostic imaging, is to identify all alterations through non-invasive and highly-accurate early diagnosis with minimum stress for the patient [7]. Multi-detector row computed tomography (MDCT) offers the best longitudinal and temporal resolution essential for the traumatized patient and, nowadays, represents the gold standard of imaging in the Emergency Room [9]. High-speed technique even for large volumes allows high 0720-048X/$ – see front matter © 2007 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.ejrad.2007.09.023