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High rates of clinically relevant incidental findings by total-body CT scanning in trauma patients; results of the REACT-2 trial.

Abstract：

OBJECTIVES:To determine whether there is a difference in frequency and clinical relevance of incidental findings detected by total-body computed tomography scanning (TBCT) compared to those by the standard work-up (STWU) with selective computed tomography (CT) scanning. METHODS:Trauma patients from five trauma centres were randomized between April 2011 and January 2014 to TBCT imaging or STWU consisting of conventional imaging with selective CT scanning. Incidental findings were divided into three categories: 1) major finding, may cause mortality; 2) moderate finding, may cause morbidity; and 3) minor finding, hardly relevant. Generalized estimating equations were applied to assess differences in incidental findings. RESULTS:In total, 1083 patients were enrolled, of which 541 patients (49.9 %) were randomized for TBCT and 542 patients (50.1 %) for STWU. Major findings were detected in 23 patients (4.3 %) in the TBCT group compared to 9 patients (1.7 %) in the STWU group (adjusted rate ratio 2.851; 95%CI 1.337-6.077; p < 0.007). Findings of moderate relevance were detected in 120 patients (22.2 %) in the TBCT group compared to 86 patients (15.9 %) in the STWU group (adjusted rate ratio 1.421; 95%CI 1.088-1.854; p < 0.010). CONCLUSIONS:Compared to selective CT scanning, more patients with clinically relevant incidental findings can be expected by TBCT scanning. KEY POINTS:• Total-body CT scanning in trauma results in 1.5 times more incidental findings. • Evaluation by TBCT in trauma results in more patients with incidental findings. • In every category of clinical relevance, TBCT detects more incidental findings.

journal_name

Eur Radiol

journal_title

European radiology

authors

Treskes K,Bos SA,Beenen LFM,Sierink JC,Edwards MJR,Beuker BJA,Muradin GSR,Hohmann J,Luitse JSK,Hollmann MW,Dijkgraaf MGW,Goslings JC,REACT-2 study group.

doi

10.1007/s00330-016-4598-6

subject

Has Abstract

pub_date

2017-06-01 00:00:00

pages

2451-2462

issue

eissn

0938-7994

issn

1432-1084

pii

10.1007/s00330-016-4598-6

journal_volume

pub_type

杂志文章,多中心研究,随机对照试验

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High rates of clinically relevant incidental findings by total-body CT scanning in trauma patients; results of the REACT-2 trial.