Value of double reading of whole body CT in polytrauma patients; [Intérêt de la double lecture du scanner corps entier dans la prise en charge des polytraumatisés]

Purpose. To assess the value of standard double reading of whole body CT in the management of polytrauma patients. Materials and methods. Prospective study between January and July 2005. Two senior radiologists with expertise in trauma imaging, blinded to clinical findings, reviewed 105 initial CT examinations of polytrauma patients. These examinations had initially been interpreted by the on-call radiologist. The second interpretations were performed within 12 hours of admission, and were considered the gold standard. Results. A total of 105 patients were included with 82 males (78%) and 23 females (22%), aged between 2 and 83 years. The level of admission was graded III (nCombining double low line64), II (nCombining double low line30) and I (nCombining double low line11). The second reading identified 3 lesions that were not initially described, each requiring a change in management, including splenic rupture (nCombining double low line1), thoracic spine fracture (nCombining double low line1) and epidural hematoma (nCombining double low line1), with no unfavorable impact on mortality. Additional errors in the initial interpretation were identified: peripheral fractures (nCombining double low line38), chest (nCombining double low line36), brain (nCombining double low line31), abdominal (nCombining double low line28), spine (nCombining double low line19) and maxillofacial (17) lesions and contrast extravasation (nCombining double low line6). Conclusion. Based on the large number and severity of some lesions missed at initial interpretation of whole body CT of polytrauma patients, we recommend standard double reading of these examinations. © Éditions Françaises de Radiologie, Paris, 2008. Édité par Elsevier Masson SAS.