Table 13 Section 6: Whole Body CT – Protocol, key issue 4: contrast phase
Key question: What is the optimal phase for contrast enhanced emergency polytrauma imaging? | ||||
|---|---|---|---|---|
No | Statement(s) | Cons | Grade | Cons |
6.4.1 | The choice of the injection protocol should be individually adapted to the patient and their clinical condition, in particular with regard to dose aspects and required diagnostic significance | 86% normal | GPP A | 86% normal |
6.4.2 | An unenhanced phase may be considered to be performed in case of question of blood components outside a vascular lumen | 57% weak | GoR 0 | 57% weak |
6.4.3 | For a given indication, it may be considered to calculate an unenhanced phase using the dual-energy technique | 100% strong | GoR 0 | 100% strong |
6.4.4 | Purely unenhanced CT imaging should not be performed on the trunk of the body | 100% strong | GoR A | 86% normal |
6.4.5 | A split bolus protocol ought to be part of a dose-optimised protocol | 71% weak | GPP B | 57% weak |
6.4.6 | Where a split bolus protocol identifies questionable relevant findings, the region in question ought to be supplemented with an additional appropriate further phase | 100% strong | GPP B | 100% strong |
6.4.7 | For a protocol with a focus on highest diagnostic precision, at least the upper abdomen should be depicted in both the arterial and venous phases | 86% normal | GoR A | 100% strong |
6.4.8 | For image findings suspicious of active bleeding, at least two temporally separated contrast phases ought to be present to estimate the activity | 100% strong | GoR B | 86% normal |
Literature: detected = 2518, excluded = 2450, full-text: rated = 68, excluded = 22, included = 46 (guideline: [15, 19, 24, 48, 79, 90,91,92,93,94,95,96,97,98]; level 1: [99]; level 2: [25, 26, 28, 55, 56, 65, 89, 100,101,102,103]; level 3: [16, 27, 29, 51, 52, 54, 57, 58, 61,62,63, 70, 72, 74, 75, 104,105,106,107,108]) | ||||
Comments: The section deals with intravenous contrast media. Mainly for time reasons oral or rectal filling is inappropriate / obsolete | ||||