Non-trauma associated incidental findings in emergency CT examinations in patients with trauma

Tan Yuan-man; Ding Ke; Lu Shan-jin; Wei Xue; He Fei

doi:10.3969/j.issn.1002-1949.2017.11.016

Abstract：Objective To investigate the non-detection of non-trauma associated incidental findings (IFs) and clinical relevance classification of them in emergency CT examinations in patients with trauma.Methods We conducted a retrospective analysis of emergency CT scan images of 306 traumatic patients whose were referred to our department at night,between June 1st 2014 and November 30th 2015.The images were independently evaluated by two radiologists,and the incidental findings were observed that compared with the primary archived reports to determine the non-detection rate.The clinical relevance of incidental findings were classified by the modified CT Colonography Reporting and Data System(C-RADS).Results A total of 159 IFs were found in 125 of 306 traumatic patients undergoing spiral CT examinations (40.8％).A total of 3 out of them (1.9％) were categorized E1 (anatomic variant),87 (54.7％) were categorized E2 (clinically unimportant finding),58 (36.5％) were categorized E3 (likely unimportant finding),and 11 (6.9％) were categorized E4 (potentially important finding).A total of 43 of 125 findings were not mentioned in the archived reports for a nondetection rate of 27.0％,and the non-detection rate of E4 was 9.3％ (4/43).Conclusion It is important to pay attention to the diagnosis of non-trauma associated incidental findings in the traumatic patients,possibly,to avoid or reduce the non-detection of incidental findings.Using the C-RADS model for the clinical relevance classification of non-trauma associated incidental findings is helpful to judgment the severity of lesions.