ARRS 2022 Abstracts

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E2006. A Regional Trauma Centre Experience- Incidental Findings on Total-body CT Scans in Trauma Patients
Authors
  1. Reut Anconina; Toronto General Hospital
  2. Navneet Singh; Sunnybrook Hospital
Background
Advances in technology and availability of CT has led to its increasing use in trauma patients. Whole-body CT is now recommended as a standard of care in the management of hemodynamically stable polytrauma patients. CT imaging utilization improves the survival of trauma patients but also leads to detection of incidental findings that are generally found with a greater prevalence in older patients. The frequency of incidental findings is highest in the chest and abdomen, with incidental findings reported in a third to half of patients undergoing whole-body CT examination. Clinically significant findings are much less frequent and range between 3% and 5% of cases. Recognizing these findings and communicating them with further recommendations provides an opportunity for early diagnosis and treatment and improves patient prognosis.

Educational Goals / Teaching Points
The goal of this educational exhibit is to review common incidental findings found on total-body CT in trauma patients and provide case examples from a high-volume regional trauma center. We will discuss imaging findings and guideline recommendations for cases representing the spectrum of clinical significance of commonly observed incidental findings based on three major categories: 1) findings that need immediate attention; 2) findings that will need further follow- up or non-urgent assessment; and 3) true ‘incidentalomas’ that do not need any further attention.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Radiographic imaging still remains the first step in that imaging assessment, it provides a rough overview and allows detection of life threatening conditions, especially in the chest and pelvis. CT, which provides better detection of the patient's injuries and severity, is performed in most cases. With that, there is increasing detection of incidental finding in those imaging studies. This exhibit will review: 1) total-body trauma imaging protocols; 2) review common incidental findings and their frequencies; 3) share images from a regional trauma center experience; and 4) review common guidelines on further recommendations.

Conclusion
Clinically relevant findings can be expected with the increasing use of total-body imaging in the assessment of trauma. The radiologist’s ability to detect and suggest significant findings is useful, as findings can range from clinically insignificant findings, such as adrenal adenomas and calcified lung granulomas, to potentially life-threatening findings, such as acute pulmonary embolism or perforated cholecystitis, as demonstrated in this exhibit. Radiologists’ ability to give the appropriate recommendations for each finding on the basis of common radiology follow-up guidelines may be helpful in the management of patients.