Interpretation of emergency CT scans in polytrauma: trauma surgeon vs radiologist

Parag, Priyashini; Hardcastle, Timothy Craig

doi:10.1016/j.afjem.2020.01.008

Cited by 18 publications

(14 citation statements)

References 25 publications

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“…The pan CT allows for injury severity classification using the American Association for the Surgery of Trauma abbreviated injury scale and assists in non-operative solid organ trauma management as demonstrated in figure 1. Even with the lack of radiologist resources in many places the pan CT can be safely viewed by the experienced trauma surgeon with highly valid decisionmaking and low missed injury or error rates [17,18]. The Pan CT is best performed with a standard protocol that consists of the following: non-contrasted head; non-contrasted cervical spine; an arterial phase from the neck at the skullbase including the chest and abdominal vessels, down to the feet if there are lower limb injuries and the portal venous phase for abdominal organ injury identification.…”

Section: Pan Ct (Whole Body Ct)mentioning

confidence: 99%

The Role of CT Scan in the Work-Up and Management of Blunt and Penetrating Trauma and Acute Surgical Emergencies - A Focused Literature Review

Shangase¹,

Hardcastle²

2023

Preprint

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Background: Trauma is the leading cause of morbidity and mortality in young patients, acute surgical conditions cause morbidity and mortality in patients of all ages. Computed tomography scan (CT) assist greatly in the investigation and management of these patients with blunt and penetrating trauma, facilitating early diagnosis and expedites early appropriate treatment of these patients. Acute non-traumatic surgical conditions also mimic non-surgical pathologies and differentiating the two is important because management is different and any delay in surgical intervention results in high morbidity and some may even result in mortality. Method: Literature review of the role of multidetector CT scan (MDCT) in managing acute surgical emergencies and trauma-diagnosis in the trauma patient and patients presenting with acute surgical emergencies. The focus is on the role of the MDCT in the management of these patients. Results highlight that the use of MDCT expedites management of these patients, allowing early surgical intervention and preventing unnecessary surgical interventions where the intervention is not indicated, based on the MDCT results. Conclusion: This paper emphasizes the important role that is played by the MDCT in the management of the above patients.

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Section: Pan Ct (Whole Body Ct)mentioning

confidence: 99%

The Role of CT Scan in the Work-Up and Management of Blunt and Penetrating Trauma and Acute Surgical Emergencies - A Focused Literature Review

Shangase¹,

Hardcastle²

2023

Preprint

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“…Various imaging techniques could be used, alone or in association, to successfully assess patients after liver resection. The imaging techniques most commonly used in the detection and characterization of complications are Ultrasound (US) [ 84 , 85 , 86 , 87 ] and contrast-enhanced CT (CECT) [ 88 , 89 , 90 , 91 , 92 , 93 , 94 , 95 , 96 , 97 , 98 , 99 , 100 , 101 ].…”

Section: Complicationsmentioning

confidence: 99%

Imaging Features of Post Main Hepatectomy Complications: The Radiologist Challenging

et al. 2022

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In the recent years, the number of liver resections has seen an impressive growth. Usually, hepatic resections remain the treatment of various liver diseases, such as malignant tumors, benign tumors, hydatid disease, and abscesses. Despite technical advancements and tremendous experience in the field of liver resection of specialized centers, there are moderately high rates of postoperative morbidity and mortality, especially in high-risk and older patient populations. Although ultrasonography is usually the first-line imaging examination for postoperative complications, Computed Tomography (CT) is the imaging tool of choice in emergency settings due to its capability to assess the whole body in a few seconds and detect all possible complications. Magnetic resonance cholangiopancreatography (MRCP) is the imaging modality of choice for delineating early postoperative bile duct injuries and ischemic cholangitis that may arise in the late postoperative phase. Moreover, both MDCT and MRCP can precisely detect tumor recurrence. Consequently, radiologists should have knowledge of these surgical procedures for better comprehension of postoperative changes and recognition of the radiological features of various postoperative complications.

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“…This study is one of a three-part study for a PhD thesis, comparing the surgical and radiologist interpretation of CT scans in trauma in a resource restricted environment. The other studies examine the difference in radiologist and vascular surgeon interpretation of CT angiograms in trauma and radiologist and trauma surgeon interpretation of whole-body CT scans in polytrauma [14].…”

Section: Introductionmentioning

confidence: 99%

Interpretation of Emergency CT Scans of the Head in Trauma: Neurosurgeon vs Radiologist

Parag

Hardcastle

2022

World j. surg.

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Background Traumatic brain injury (TBI) is a major cause of mortality and morbidity across all ages in all countries. Management of the patient with TBI is time critical. Emergency computed tomography (CT) scans of the head are often assessed by neurosurgeons and patient management plans are implemented before the final radiological report is released in hospitals, particularly where there is a shortage of radiologists in LMIC. The aims of this study were to identify discrepancies in the interpretation of CT scans of the head in patients with isolated head injury between the neurosurgeon and radiologist and to assess if these differences impacted patient management. Methods This 6-month long prospective observational study was performed at a tertiary hospital in South Africa. The study population comprised 347 patients with isolated head injury who had a CT scan of the head performed on admission. The neurosurgeons' initial CT scan interpretation and the final radiological report were compared. Results Out of 347 CT head scans, the neurosurgeons correctly interpreted 318 cases. Of the 29 incorrectly interpreted cases, there were 17 false negatives and 12 cases with mismatching abnormalities. The concordance rate was 91.64% (95% CI 88.73-94.55) with a kappa of 0.78. An accuracy rate of 95.33% (95% CI 92.63-97.26) was achieved by the neurosurgeon. No patient was negatively impacted by any neurosurgical error in misinterpretation. Conclusions In the interpretation of CT head scans in trauma, there is good neurosurgical and radiological interobserver agreement without negative patient impact. The neurosurgeons' interpretation of CT scans of the head in TBI is safe especially when radiology reports are not timeously available.

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Interpretation of emergency CT scans in polytrauma: trauma surgeon vs radiologist

Cited by 18 publications

References 25 publications

The Role of CT Scan in the Work-Up and Management of Blunt and Penetrating Trauma and Acute Surgical Emergencies - A Focused Literature Review

The Role of CT Scan in the Work-Up and Management of Blunt and Penetrating Trauma and Acute Surgical Emergencies - A Focused Literature Review

Imaging Features of Post Main Hepatectomy Complications: The Radiologist Challenging

Interpretation of Emergency CT Scans of the Head in Trauma: Neurosurgeon vs Radiologist

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