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- W2080496470 abstract "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 (n=64), II (n=30) and I (n=11). The second reading identified 3 lesions that were not initially described, each requiring a change in management, including splenic rupture (n=1), thoracic spine fracture (n=1) and epidural hematoma (n=1), with no unfavorable impact on mortality. Additional errors in the initial interpretation were identified: peripheral fractures (n=38), chest (n=36), brain (n=31), abdominal (n=28), spine (n=19) and maxillofacial (17) lesions and contrast extravasation (n=6). 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. Objectifs. Évaluer l’intérêt d’une relecture systématique des scanners corps entier dans l’impact thérapeutique de patients polytraumatisés admis au déchoquage. Matériels et méthodes. Nous avons réalisé une étude prospective sur une période de 7 mois (janvier à juillet 2005). Deux radiologues seniors spécialisés en imagerie du traumatisé, sans connaissance de la clinique ont interprété 105 scanners réalisés lors de la prise en charge de patients polytraumatisés. Ces scanners avaient été interprétés initialement par le radiologue de garde. La seconde lecture a été faite en moyenne dans les 12 heures après l’admission du patient, et a été considérée comme l’examen de référence. Résultats. Cette étude a porté sur 105 patients dont 82 hommes (78 %) et 23 femmes (22 %), âgés de 2 à 83 ans. Le niveau à l’admission a été coté niveau III (n = 64), II (n = 30) et I (n = 11). La seconde lecture a identifié 3 lésions non décrites initialement ayant nécessité une modification thérapeutique, à savoir une rupture splénique (n = 1), une fracture du rachis dorsal (n = 1) et un hématome extradural (n = 1), sans conséquence en terme de mortalité. Par ailleurs des erreurs dans l’interprétation initiale ont été identifiées : fractures ostéoarticulaires périphériques (n = 38), lésions thoraciques (n = 36), cérébrale (n = 31), abdominale (n = 28), rachidien (n = 19), face (n = 17), et extravasation de contraste (n = 6). Conclusion. Devant le nombre important et la gravité de certaines lésions passées inaperçues lors de la première interprétation des scanners corps entier de patients polytraumatisés, nous recommandons une relecture systématique des clichés." @default.
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- W2080496470 date "2008-03-01" @default.
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- W2080496470 title "Intérêt de la double lecture du scanner corps entier dans la prise en charge des polytraumatisés" @default.
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- W2080496470 doi "https://doi.org/10.1016/s0221-0363(08)93007-9" @default.
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