What is the role of CT scanning in the diagnosis of fat embolism?

Updated: Mar 26, 2018
  • Author: Constantine S Bulauitan, MD; Chief Editor: Vincent Lopez Rowe, MD  more...
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Answer

Findings from noncontrast computed tomography (CT) of the head performed because of alterations in mental status may be normal or may reveal diffuse white-matter petechial hemorrhages consistent with microvascular injury.

Because the embolic particles are lodged in the capillary beds, helical CT findings may be normal. Parenchymal changes consistent with lung contusion, acute lung injury, or acute respiratory distress syndrome (ARDS) may be evident, depending on the burden of secondary lung injury.

Nodular or ground-glass opacities in the setting of trauma suggest fat embolism. [18]  In one retrospective review, ground-glass opacities in the setting of trauma were the most common findingings on helical chest CT; 67% of all FES subjects enrolled had ground-glass opacities. [19] The presence of ground-glass opacities involving more than 75% of lung parenchyma with the concomitant presence of consolidation correlates with disease severity. [19, 17]


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