[Non-trauma-associated additional findings in whole-body CT examinations in patients with multiple trauma]

Abstract

Purpose: Whole-body CT scans for patients with multiple trauma represent an increasingly accepted first diagnostic tool. The multidetector approach in particular provides appropriate diagnostic algorithms for detecting nearly all relevant traumatic findings in a short time with a high grade of sensitivity and specificity. Non-trauma-associated additional findings are commonly depicted based on these CT examinations. The aim of this study is to evaluate the number and quality of these additional findings in consecutive patients with multiple trauma.

Materials and methods: Between 3 / 04 and 8 / 06 we scanned 304 patients according to our dedicated multiple trauma protocol. The examination protocol includes a head scan without intravenous contrast followed by a whole-body scan including the neck, thorax and abdomen acquired by a 16-row CT Scanner (Siemens, Sensation 16). The CT scans were retrospectively analyzed by two radiologists with respect to non-trauma-associated findings. Lesions were assessed according to their clinical relevance (highly relevant, moderately relevant, not relevant). For patients with highly relevant findings, additional follow-up research was performed.

Results: The average age was 43 years (range 3 - 92). 236 of the patients were male (77.6 %), 68 female (22.4 %). 153 patients (50.3 %) had additional non-trauma-associated findings. In 20 cases (6.6 %) lesions with high clinical relevance were detected (e. g. carcinoma of the kidney or the ovary). In 71 patients (23.4 %) findings with moderate relevance were described. In 63 patients (20.7 %) additional findings without major relevance were diagnosed.

Conclusion: Whole-body CT scans of patients randomized by a trauma show a considerable number of non-trauma-associated additional findings. In about 30 % of cases, these findings are clinically relevant because further diagnostic workup or treatment in the short or medium-term is needed. The results of these analyses emphasize the diagnostic value of CT examinations with high demands on the examining radiologist.