Martin Helmut Maurer MD, Presenter: Nothing to Disclose

Eduard Kroczek, Abstract Co-Author: Nothing to Disclose

In patients with suspected multiple trauma whole-body computed tomography (wbCT) is the gold standard in the initial diagnostic work-up. As wbCT gives not only a rapid and precise overview on traumatic lesions it may also reveal associated non-traumatic findings of variable clinical importance. The aim of this study was to evaluate the number and quality of such incidental findings in patients that underwent whole-body CT examination due to suspected multiple trauma in a Level I trauma center.

In a retrospective study between 2009 and 2013 a total of 2,909 patients (1,909 male, 800 female) with suspected multiple trauma were retrospectively analyzed with regard to non-trauma-associated incidental findings obtained in whole-body CT examination at initial admission. Findings were categorized by two readers in consensus according to the body region (head, neck, thorax, abdomen/pelvis, musculoskeletal system) and their clinical importance (category 1=further diagnostic work-up or therapeutic intervention urgently needed within initial hospitalization; 2= further work-up needed within less than 3 months; 3= findings that may result in health problems in the future; 4= benign incidental finding, no further work-up needed, variants).

Overall, 5,997 incidental findings were documented in 2,074 patients, thereof 1,135 in the head, 262 at the neck, 1,280 in the thorax, 2,541 in the abdomen and 779 findings of the musculoskeletal system. There were 294 patients (9.9%) with a category 1 finding where further work-up or therapy was urgently needed, 673 patients (24.8%) with a category 2 finding, 775 patients (28.6%) with a category 3 finding and 332 patients (12.2%) with a category 4 finding.

Whole-body CT scans of patients with a suspected multiple trauma show a considerable number of non-trauma-associated incidental findings. There was at least one incidental finding in one out of two patients and a finding requiring urgent follow-up or therapy in one out of ten patients.

In patients initially imaged with wbCT for suspected multiple trauma, radiologists and trauma surgeons must be aware of a high number of non-traumatic incidental findings with clinical relevance.

Maurer, M, Kroczek, E, Non-trauma-associated Incidental Findings in Whole-body CT Examinations in Patients with Suspected Multiple Trauma.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14014561.html