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Table 11 Section 6: Whole Body CT – Protocol, key issue 2: Cranial CT

From: European Society of Emergency Radiology: guideline on radiological polytrauma imaging and service (short version)

Is an unenhanced cranial scan preferred to a cranial scan with contrast medium as first imaging option in the whole-body tomography scan of the polytrauma patient?
No Statement(s) Cons Grade Cons
6.2.1 The full body tomography scan of the polytrauma patient should begin with an unenhanced cranial CT scan 100%
strong
GoR
A
100%
strong
6.2.2 Depending on the findings and symptoms, an additional cranial CTA (computed tomography angiography) may be considered as useful 86%
normal
GoR
0
86%
normal
Literature: detected = 2266, excluded = 2228, full-text: rated = 38, excluded = 13, included = 25 (guideline: [15, 19, 64]; level 2: [25, 28, 55, 56, 65]; level 3: [16, 26, 27, 29, 51, 58, 61, 66,67,68,69,70,71,72,73,74,75])
Comments: Virtual unenhanced CT imaging with Dual Energy techniques should undergo more scientific evaluation. Maybe this method will allow single enhanced cranial CT scanning with sufficient detection rates of intracranial bleedings by virtual unenhanced imaging. If so, this may have the potential for both speeding up service and reducing the dose