Difference between revisions of "CT of the neck in trauma"
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==Evaluation== | ==Evaluation== | ||
| + | [[File:Computed tomographs of normal cervical vertebrae (thumbnail).jpg|thumb|link=Commons:Scrollable computed tomography images of normal cervical vertebrae|Normal cervical vertebrae {{noprint|[[Commons:Scrollable computed tomography images of normal cervical vertebrae|(Click here to scroll through the image stacks)]]}}]] | ||
*Any fracture lines? | *Any fracture lines? | ||
*Incongruences? Lines drawn along the anterior and posterior surfaces of vertebrae as well as the spinous processes should be smooth. Also, the distances between vertebrae and spinous processes should be compared. | *Incongruences? Lines drawn along the anterior and posterior surfaces of vertebrae as well as the spinous processes should be smooth. Also, the distances between vertebrae and spinous processes should be compared. | ||
Revision as of 18:02, 16 April 2019
Author:
Mikael Häggström [notes 1]
Contents
Planning
Choice of modality
Recommendations differ somewhat between children and adults:
- In children, CT of the neck in trauma is indicated in more severe cases such as neurologic deficits, whereas X-ray of the cervical spine is preferable in milder cases, by both US[1] and UK[2] guidelines. Swedish guidelines recommend CT rather than X-ray in all children over the age of 5.[3] It is thus reasonable to indicate CT by a combination of higher severity and older age.
- In adults, UK guidelines are largely similar as in children.[2] US guidelines, on the other hand, recommend CT of the neck in trauma in all cases where medical imaging is indicated, and that X-ray of the cervical spine is only acceptable where CT is not readily available.[4]
Settings
Thin slices, ideally 1.5 mm or less.[5]
Evaluation
- Any fracture lines?
- Incongruences? Lines drawn along the anterior and posterior surfaces of vertebrae as well as the spinous processes should be smooth. Also, the distances between vertebrae and spinous processes should be compared.
- Prevertebral thickening?
Prevertebral thickening
Upper limits of values vary with body constitution of the patient, but in adults they are generally:[6]
- C1: 8.5 mm
- C2: 6 mm
- C3: 7 mm
- C4/C5: variable due to variable height for cricoid/oesophagus
- C6: 18 mm
- C7: 18 mm
The following are upper limits for prevertebral spaces in children:[7]
| Age | C2 | C6 |
|---|---|---|
| 0-2 years | 7.6 mm | 9.0 mm |
| 3-6 years | 8.4 mm | 9.8 mm |
| 7-10 years | 6.8 mm | 12.1 mm |
| 11-15 years | 6.8 mm | 14.5 mm |
Report
Even absence of:
- Fracture
- Misalignment
- Prevertebral thickening
Notes
- ↑ For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Radlines:Authorship for details.
References
- ↑ Julie C Leonard (2018-02-12). Evaluation and acute management of cervical spine injuries in children and adolescents. UpToDate.
- ↑ 2.0 2.1 . Head injury: assessment and early management. National Institute for Health and Care Excellence (NICE) (2014). Updated in June 2017
- ↑ . Traumamanual. Region Skåne. Last updated: 2018-03-29
- ↑ Amy Kaji, Robert S Hockberger (2018-05-24). Evaluation and acute management of cervical spinal column injuries in adults.
- ↑ Tins, Bernhard (2010). "Technical aspects of CT imaging of the spine ". Insights into Imaging 1 (5-6): 349–359. doi:. ISSN 1869-4101.
- ↑ Rojas, C.A.; Vermess, D.; Bertozzi, J.C.; Whitlow, J.; Guidi, C.; Martinez, C.R. (2009). "Normal Thickness and Appearance of the Prevertebral Soft Tissues on Multidetector CT ". American Journal of Neuroradiology 30 (1): 136–141. doi:. ISSN 0195-6108.
- ↑ Error on call to Template:cite web: Parameters url and title must be specifiedJeremy Jones. . Radiopaedia.
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