Public Release: 

Plain radiographs and dedicated CT may become unnecessary in detecting lower spine fractures

American College of Radiology

Multidetector computed tomography (MDCT) of the abdomen and pelvis with immediate 3D reconstruction may soon do away with the necessity of performing plain radiographs and dedicated spinal CT imaging in trauma patients, according to a new study by researchers from Boston Medical Center and Boston University in Massachusetts.

The retrospective study involved 100 emergency room patients with abdominal trauma who underwent both imaging techniques. The study revealed that fractures of the lower spine were detected in 36 patients using MDCT, but in only 28 patients on plain radiographs. Additionally, a total of 42 transverse process fractures were identified in 20 patients on MDCT; 26 were identified in 13 patients on plain radiographs.

According to the study, the benefits gleaned by using MDCT rather than plain radiographs include savings of both time and cost and improvements in patient care. "You no longer have to physically take the time to obtain the radiographs, which can take 10-15 minutes--a long time for a trauma patient. You no longer use the equipment or take up the technologist's time to obtain the radiographs. Patient care is improved as the spine is evaluated with increased accuracy and also more quickly, allowing for early optimal treatment to be instituted," said Brian Lucey, MD, lead author of the study.

According to the authors, very little stands in the way of MDCT superseding plain radiographs for this purpose in the future. "The only obstacle to replacing plain films is the availability of MDCT and the accompanying 3D online software package. In our setting, we have already dispensed with the plain films," said Dr. Lucey.

Dr. Lucey will present the study on May 4 during the American Roentgen Ray Society Annual Meeting in Miami Beach, FL.


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