Background: To reduce the possibility of secondary deterioration of spinal injuries, it is desirable to maintain the\nspinal immobilisation that is applied in the prehospital setting throughout computed tomography (CT) scanning. A\nprevious study found that metallic components within the inflation valve of the vacuum mattresses caused CT artefacts.\nThe aim of our study was to investigate the effect of vacuum mattresses with plastic valves on CT artefacts, the radiation\ndose, and noise compared to a trauma transfer board and the spine boards currently used in our trauma system.\nMethods: We scanned an anthropomorphic whole body phantom with different immobilisation devices on a 128-slice\nCT scanner using the standard polytrauma CT-protocol at our institution. The phantom was scanned without any\nimmobilisation device and with three different vacuum mattresses, two spine boards, and one trauma transfer board.\nTwo radiologists independently assessed the artefacts. Agreement between the two radiologists was measured using\nthe kappa coefficient. The radiation dose and noise were assessed.\nResults: One spine board produced major artefacts due to its metal components. One of the vacuum mattresses\nresulted in artefacts that impaired clinical judgement. Otherwise, the artefacts predominantly did not impede clinical\njudgement and were mainly subtle. One of the vacuum mattresses resulted in no artefacts that affected clinical judgement.\nThe overall inter-rater agreement was substantial (0.86, kappa 0.77). We did not observe any artefacts due to plastic valves.\nThe mean CT radiation dose was slightly higher for two of the devices in the head series than that for the trauma transfer\nboard, used as the standard in our system. Only marginal differences were noted for the other devices and series. Small\ndifferences in image noise were found between the devices.\nConclusions: Our results indicate that it is feasible to maintain some vacuum mattresses with plastic valves on trauma\npatients during CT scanning. The tested mattresses did not result in a considerably increased radiation dose or artefacts\nthat hampered clinical judgement. One of the tested vacuum mattresses produced no artefacts that hampered clinical\njudgement whatsoever.
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