Previous studies have utilized three-dimensional computed tomography (CT) in the evaluation of injury. The CIREN database currently collects two-dimensional x-ray, CT, and MRI data, and 2-D snapshots of injuries, of both hard and soft tissues, are collected and stored in the database. Prior to and during case reviews CIREN centers have at their disposal three-dimensional image analysis tools. These tools are sometimes cumbersome and difficult to use and to quickly view injuries in real time can be very difficult. This is unfortunate given the tremendous insight which can be gained into injury mechanisms by looking at three- dimensional data.

This study presents the use of a combined software and hardware system for the exploration and visualization of three-dimensional CT datasets for the analysis of CIREN data. The benefit of such a system is that 3-D anatomical imagery can be manipulated in real time, and the thresholds and rendering can be adjusted based on feedback from the large number of medical and engineering experts present at case review. Examples from a subset of CIREN cases are provided for children, the elderly, the pregnant occupant, and normal adults. The reconstruction method provides insight into the location and severity of pulmonary contusion, the presence or absence of superficial soft tissue injuries due to restraint loading, or other contacts which are not always present using photographic or two-dimensional radiologic evidence. Three-dimensional visualization of internal organ injuries provides insight into potential mechanisms of soft tissue injury and the interaction of soft and hard tissues of the body during the impact. Examples of reconstructions are provided.

In short, three-dimensional medical image data from patients, particularly those involved in crashes where the crash characteristics are known, may be very valuable as an indicator of direction of impact and severity and mechanism of injury. This is demonstrated through the use of multimedia real-time analyses of injuries for a subset of CIREN cases.