Body

Table of Contents


Trauma

Radiology Assistant: CT in Trauma

AAST Injury Scoring Scales (all organs)

FluidHounsfield Units
Simple Fluid0-10
Bile-80-20
Urine0-20
Contrasted Urine80-200
Unenhanced Clotted Blood30-45
Clotted Blood60-90
Serum0-20
Contrast Enhanced Blood120+

Kidney

Source: Radiopaedia
GradeDescription
Grade ISubcapsular hematoma and/or parenchymal contusion without laceration
Grade IIPerirenal hematoma confined to Gerota fascia
Renal parenchymal laceration ≤1 cm depth without urinary extravasation
Grade IIIRenal parenchymal laceration >1 cm depth without collecting system rupture or urinary extravasation
Any injury in the presence of a kidney vascular injury or active bleeding contained within Gerota fascia
Grade IVParenchymal laceration extending into urinary\ collecting system with urinary extravasation
Renal pelvis laceration and/or complete ureteropelvic disruption
Segmental renal vein or artery injury
Active bleeding beyond Gerota fascia into the retroperitoneum or peritoneum
Segmental or complete kidney infarction(s) due to vessel thrombosis without active bleeding
Grade VMain renal artery or vein laceration or avulsion of hilum
Devascularized kidney with active bleeding
Shattered kidney with loss of identifiable parenchymal renal anatomy

Liver Injury

Source: Radiopaedia
GradeDescription
Grade ISubcapsular hematoma <10% surface area
Parenchymal laceration <1 cm in depth
Grade IISubcapsular hematoma 10–50% surface area
intraparenchymal hematoma <10 cm in diameter
Laceration 1–3 cmin depth and ≤ 10 cm length
Grade IIISubcapsular hematoma >50% surface area
ruptured subcapsular or parenchymal hematoma
Intraparenchymal hematoma >10 cm
Laceration >3 cm depth
Any injury in the presence of a liver vascular injury or active bleeding contained within liver parenchyma
Grade IVParenchymal disruption involving 25–75% of a hepatic lobe
Active bleeding extending beyond the liver parenchyma into the peritoneum
Grade VParenchymal disruption >75% of hepatic lobe
Juxtahepatic venous injury to include retrohepatic vena cava and central major hepatic veins

Spleen

Source: Radiopaedia
GradeDescription
Grade ISubcapsular hematoma <10% surface area
Parenchymal laceration <1 cm depth
Capsular tear
Grade IISubcapsular hematoma 10–50% surface area
Intraparenchymal hematoma <5 cm
Parenchymal laceration 1–3 cm
Grade IIISubcapsular hematoma >50% surface area;
Ruptured subcapsular or intraparenchymal hematoma ≥5 cm
Parenchymal laceration >3 cm depth
Grade IVAny injury in the presence of a splenic vascular injury or active bleeding confined within splenic capsule
Parenchymal laceration involving segmental or hilar vessels producing >25% devascularization
Grade VAny injury in the presence of splenic vascular injury with active bleeding extending beyond the spleen into the peritoneum
Shattered spleen

GU

Urethral Injuries

Source: UW Emergency Radiology
GradeDescriptionNotes
Type IStretching injury to the prostatic urethraRupture of the puboprostatic ligaments
Type IIDisruption of the prostatic urethraContrast extravasates above the UG Diaphragm
Type IIIDisruption of the membranous urethraContrast extravasates into and below the UG Diaphragm
Type IVaDisruption involving the bladder neckSurgical
Type IVbBladder base rupture not involving bladder neckConservative management
Type VDisruption of the anterior urethra

Bladder Rupture

Extraperitoneal bladder rupture: non operative management.
Intraperitoneal bladder rupture – extending around loops of bowel; operative management

NON-TRAUMA RESOURCES

Adrenal

Adrenal washout calculator

Liver

Annotated CT: liver segments

Pancreatitis

RSNA: Revised Atlanta Classification for Acute Pancreatitis: A Pictorial Essay

Radiology Assistant: Acute Pancreatitis

ANC = acute necrotic collection; WON = walled-off necrosis; APFC = acute peripancreatic fluid collection. Any fluid collection can become infected and contain gas. APFC/ANC < 4 weeks from symptoms, pseudocyst/WON >4 weeks.