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Whole-Body CT Can Miss Injuries


Older age, multiple traumas lead to missed injuries on whole-body CT.

Three predictive factors can all result in missed injury at whole-body CT, according to a study published online in the journal Radiology.

Researchers from France performed a retrospective study to determine radiologic and clinical markers predictive of missed injuries at early whole-body CT image interpretation.

A total of 2,354 whole-body CT examinations were examined for the study. The patients presented with multiple traumas and the images were interpreted at a teleradiology center study during on-call period from February 2011 to September 2016. All whole-body CT images were interpreted by the on-call radiologist and reviewed within 12 to 48 hours by another radiologist to detect missed injury as the standard of reference. The first and review reports of all examinations were retrospectively reviewed.

The results included images from 639 women (27.1 percent) and 1,715 men (72.8 percent), median age was 34 years, ranging from one to 96 years. On a per-scan basis, there were 304 (12.9 percent) missed injuries and 59 (2.5 percent) were clinically significant. On a per-injury basis, the missed injury rate was 530 of 5,979 (8.8 percent). Independent predictive factors for missed injury were:

• More than two injured body parts
• Patient age older than 30 years
• Initial clinical severity class of 1

The researchers concluded that patients who presented with these three factors could have missed injuries at whole-body CT.

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