Combined arterial and portal venous phase trauma CT

Case contributed by Dr Andrew Dixon


Car accident with suspected chest and abdominal injuries.

Patient Data

Age: 35 years
Gender: Male

Normal study.

Case Discussion

Combined arterial and portal venous phase body trauma CT. Intravenous contrast is administered in two boluses so that the scan is timed for combined portal venous phase and arterial phase. This technique means that the whole region is covered in one single scan and means that arterial / angiographic information is obtained for the entire abdomen and pelvis (critical to detection and management of bleeding), whilst at the same time allowing homogeneous portal venous phase assessment of the solid abdominal organs. This technique involves a greater contrast volume to be administered compared to traditional two scan CT chest and abdomen techniques but reduces radiation dose as the upper abdomen overlap region is not scanned twice. The radiation dose saving is even further enhanced in patients with suspected internal bleeding who traditionally may have had their abdomen scanned twice; once in the arterial phase and once in a more delayed phase.

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