If CT imaging is performed in this patient population, the imaging time should be minimized as much as possible, and therefore without IV contrast imaging is not routinely recommended. CT Chest, Abdomen, and Pelvis Without IV Contrast There is no relevant literature regarding the use of CT chest, abdomen, and pelvis without IV contrast for initial evaluation of patients with penetrating torso trauma with hypotension. If CT imaging is performed in this patient population, IV contrast should be administered. CTA Chest, Abdomen, and Pelvis IV Contrast Most literature supporting the use of multiphase CTA imaging in the torso is derived from the blunt trauma patient population [27]. Literature suggests the detection of vascular injury is similar between routine contrast-enhanced CT of the chest and CTA of the chest; however, the justification for performing routine contrast-enhanced CT of the chest and CTA imaging was to reduce the need for two separate contrast injections [28]. Most modern-day CT Penetrating Torso Trauma scanners and protocols enable imaging of the entire body in multiple phases with one IV contrast bolus [29]. If imaging is pursued in this imaging population, single-phase imaging to include the portal venous phase may provide the most relevant information for next step imaging. MRI Chest, Abdomen, and Pelvis Without and With IV Contrast There is no relevant literature regarding the use of MRI chest, abdomen, and pelvis without and with IV contrast for initial evaluation of patients with penetrating torso trauma with hypotension. MRI Chest, Abdomen, and Pelvis Without IV Contrast There is no relevant literature regarding the use of MRI chest, abdomen, and pelvis without IV contrast for initial evaluation of patients with penetrating torso trauma with hypotension. Radiography Trauma Series Chest radiographs can recognize contusions, pneumothorax, hemothorax, rib fractures, foreign bodies and/or ballistic fragments, and mediastinal injuries, which could be treated immediately.
Penetrating Torso Trauma. If CT imaging is performed in this patient population, the imaging time should be minimized as much as possible, and therefore without IV contrast imaging is not routinely recommended. CT Chest, Abdomen, and Pelvis Without IV Contrast There is no relevant literature regarding the use of CT chest, abdomen, and pelvis without IV contrast for initial evaluation of patients with penetrating torso trauma with hypotension. If CT imaging is performed in this patient population, IV contrast should be administered. CTA Chest, Abdomen, and Pelvis IV Contrast Most literature supporting the use of multiphase CTA imaging in the torso is derived from the blunt trauma patient population [27]. Literature suggests the detection of vascular injury is similar between routine contrast-enhanced CT of the chest and CTA of the chest; however, the justification for performing routine contrast-enhanced CT of the chest and CTA imaging was to reduce the need for two separate contrast injections [28]. Most modern-day CT Penetrating Torso Trauma scanners and protocols enable imaging of the entire body in multiple phases with one IV contrast bolus [29]. If imaging is pursued in this imaging population, single-phase imaging to include the portal venous phase may provide the most relevant information for next step imaging. MRI Chest, Abdomen, and Pelvis Without and With IV Contrast There is no relevant literature regarding the use of MRI chest, abdomen, and pelvis without and with IV contrast for initial evaluation of patients with penetrating torso trauma with hypotension. MRI Chest, Abdomen, and Pelvis Without IV Contrast There is no relevant literature regarding the use of MRI chest, abdomen, and pelvis without IV contrast for initial evaluation of patients with penetrating torso trauma with hypotension. Radiography Trauma Series Chest radiographs can recognize contusions, pneumothorax, hemothorax, rib fractures, foreign bodies and/or ballistic fragments, and mediastinal injuries, which could be treated immediately.