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AJNR - American Journal of Neuroradiology

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Comparison of Low-Dose With Standard-Dose Multidetector CT in Cervical Spine Trauma

T.H. Mulkens^a, P. Marchal^a, S. Daineffe^a, R. Salgado^a, P. Bellinck^a, B. te Rijdt^b, B. Kegelaers^b and J.-L. Termote^a

^a Departments of Radiology, Heilig Hart Ziekenhuis, Lier, Belgium
^b Neurosurgery, Heilig Hart Ziekenhuis, Lier, Belgium

View larger version (43K): [in this window] [in a new window]   Fig 1. A, A 53-year-old woman after polytrauma. Sagittal 2.50 mm image of standard-dose 16-MDCT examination (120 kV and fixed 250 mAs) shows fracture at the base of the dens of C2 (arrow). Calculated effective at examination is 3.9 mSv. B, A 62-year-old man after polytrauma. Sagittal 2.5-mm image of low-dose 16-MDCT examination (100 kV and 141 mAs, after tube current modulation) shows fracture at the base of the dens of C2 (arrow). Calculated effective dose is 1.4 mSv.

View larger version (35K): [in this window] [in a new window]   Fig 2. A, A 53-year-old-man after a high-velocity motor vehicle crash with head injury. Axial 2.5-mm image shows double fracture (arrows) at the transition of the body with each posterior arc of C2. Calculated effective dose of low-dose 16-MDCT examination (100 kV and 96 mAs) is 0.98 mSv. B, Coronal 2.5-mm image shows bilateral fractures at the base of each lateral mass of C2 (arrows). C, Sagittal 2.5-mm image shows fracture at the left arc of C2 (arrow) and at the left arc of C1 (open arrow). D, Sagittal 2.5-mm image shows avulsion fracture of the posterior margin of the body of C2 (open arrow) and posterior subluxation of both posterior arches of C1 and C2 (arrows).

View larger version (25K): [in this window] [in a new window]   Fig 3. A, A 50-year-old woman with history of lung carcinoma with heavy neck pain after minor blunt cervical trauma. Axial 2.5-mm image shows bilateral osteolytic lesions in each lateral mass of the atlas (C1) (open arrows) and midline fracture (arrow) of the posterior arc of C1. Calculated effective dose of low-dose 6-MDCT examination (130 kV and 89 mAs) is 1.48 mSv. B, Coronal 2.5-mm image confirms bilateral osteolytic lesions in each lateral mass of C1 (open arrows) and transverse fracture (arrows) trough the right lateral mass.

View larger version (23K): [in this window] [in a new window]   Fig 4. A, A 25-year-old man with tetraplegia after a diving accident. Axial 2.5-mm image shows cross-like burst fracture of the body of C5 (open arrow) with posterior displacement and bilateral fractures (arrows) of the posterior arcs. Calculated effective dose of low-dose 16-MDCT examination (120 kV and 160 mAs) is 2.6 mSv. B, Sagittal 2.5-mm image shows burst fracture of the body of C5 (open arrow) with posterior displacement and spinal cord compression.

View larger version (81K): [in this window] [in a new window]   Fig 5. A 39-year-old man with hyperextension trauma of the cervical spine. Sagittal 2.5-mm image shows fracture of the spinous process of C7 (arrow). Calculated effective dose of low-dose 6-MDCT examination (110 kV and 56 mAs) is 0.78 mSv.

View larger version (36K): [in this window] [in a new window]   Fig 6. A, An 82-year-old woman with acute neck pain after a motor vehicle crash. Standard radiography, lateral view, was interpreted as negative, but additional CT was proposed because of technical failure to view the lower cervical segment C7 (superposition of the shoulders). B, Standard radiograph with odontoid view was interpreted as negative for fracture in the region of the cranio-cervical junction. C, Sagittal 2.5-mm image of low-dose 16-MDCT-examination (100 kV and 165 mAs) clearly depicts fracture (arrows) at the base of the axis (C2). D, Axial 2.5-mm image of the same low-dose CT examination shows more complex fracture of the body of C2, bilaterally extending in the lateral masses (arrows). Calculated effective dose of MDCT examination is 1.3 mSv.