Clinical Radiology
Volume 64, Issue 3 , Pages 272-283 , March 2009

Predictors of abnormal chest CT after blunt trauma: a critical appraisal of the literature

Received 1 July 2008 ,Revised 15 September 2008 ,Accepted 21 September 2008.

References 

  1. Trupka A, Waydhas C, Hallfeldt KK, et al. Value of thoracic computed tomography in the first assessment of severely injured patients with blunt chest trauma: results of a prospective study. J Trauma. 1997;43:405–411
  2. Stiell IG, Wells GA. Methodologic standards for the development of clinical decision rules in emergency medicine. Ann Emerg Med. 1999;33:437–447
  3. ACR appropriateness criteria — suspected aortic injury. Available from: http://acsearch.acr.org/ProceduresList.aspx?tid = 30601&vid = 3019088[accessed September 2008]
  4. Aucar JA, Fernandez L, Wagner-Mann C. If a picture is worth a thousand words, what is a trauma computerized tomography panel worth?. Am J Surg. 2007;194:734–739
  5. Nagy K, Fabian T, Rodman G, et al. Guidelines for the diagnosis and management of blunt aortic injury: an EAST Practice Management Guidelines Work Group. J Trauma. 2000;48:1128–1143
  6. Exadaktylos AK, Duwe J, Eckstein F, et al. The role of contrast-enhanced spiral CT imaging versus chest x-rays in surgical therapeutic concepts and thoracic aortic injury: a 29-year Swiss retrospective analysis of aortic surgery. Cardiovasc J S Afr. 2005;16:162–165
  7. Huda W. Radiation doses and risks in chest computed tomography examinations. Proc Am Thorac Soc. 2007;4:316–320
  8. Self ML, Blake AM, Whitley M, et al. The benefit of routine thoracic, abdominal, and pelvic computed tomography to evaluate trauma patients with closed head injuries. Am J Surg. 2003;186:609–613
  9. Brenner DJ, Hall DP. Computed tomography — an increasing source of radiation exposure. N Engl J Med. 2007;357:2277–2284
  10. Brenner D, Elliston C, Hall E, et al. Estimated risks of radiation-induced fatal cancer from pediatric CT. AJR Am J Roentgenol. 2001;176:289–296
  11. Amis ES, Butler PF, Applegate KE, et al. American College of Radiology white paper on radiation dose in medicine. J Am Coll Radiol. 2007;4:272–284
  12. Hunink MG, Bos JJ. Triage of patients to angiography for detection of aortic rupture after blunt chest trauma: cost-effectiveness analysis of using CT. AJR Am J Roentgenol. 1995;165:27–36
  13. Navarrete-Navarro P, Vazquez G, Bosch JM, et al. Computed tomography vs clinical and multidisciplinary procedures for early evaluation of severe abdomen and chest trauma—a cost analysis approach. Intensive Care Med. 1996;22:208–212
  14. Brasel KJ, Weigelt JA. Blunt thoracic aortic trauma. A cost–utility approach for injury detection. Arch Surg. 1996;131:619–625
  15. Staunton M. Evidence-based radiology: steps 1 and 2—asking answerable questions and searching for evidence. Radiology. 2007;242:23–31
  16. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33:159–174
  17. Whiting P, Rutjes AW, Reitsma JB, et al. The development of QUADAS: a tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews. BMC Med Res Methodol. 2003;10:25
  18. Glas AS, Lijmer JG, Prins MH, et al. The diagnostic odds ratio: a single indicator of test performance. J Clin Epidemiol. 2003;56:1129–1135
  19. Demetriades D, Gomez H, Velmahos GC, et al. Routine helical computed tomographic evaluation of the mediastinum in high-risk blunt trauma patients. Arch Surg. 1998;133:1084–1088
  20. Traub M, Stevenson M, McEvoy S, et al. The use of chest computed tomography versus chest x-ray in patients with major blunt trauma. Injury. 2007;38:43–47
  21. Plurad D, Green D, Demetriades D, et al. The increasing use of chest computed tomography for trauma: is it being overutilized?. J Trauma. 2007;62:631–635
  22. Marts B, Durham R, Shapiro M, et al. Computed tomography in the diagnosis of blunt thoracic injury. Am J Surg. 1994;168:688–692
  23. Rowan KR, Kirkpatrick AW, Liu D, et al. Traumatic pneumothorax detection with thoracic US: correlation with chest radiography and CT—initial experience. Radiology. 2002;225:210–214
  24. Soldati G, Testa A, Pignataro G, et al. The ultrasonographic deep sulcus sign in traumatic pneumothorax. Ultrasound Med Biol. 2006;32:1157–1163
  25. Exadaktylos AK, Sclabas G, Schmid SW, et al. Do we really need routine computed tomographic scanning in the primary evaluation of blunt chest trauma in patients with “normal” chest radiograph?. J Trauma. 2001;51:1173–1176
  26. Soldati G, Testa A, Sher S, et al. Occult traumatic pneumothorax: diagnostic accuracy of lung ultrasonography in the emergency department. Chest. 2008;133:204–211
  27. Soldati G, Testa A, Silva FR, et al. Chest ultrasonography in lung contusion. Chest. 2006;130:533–538
  28. Salim A, Sangthong B, Martin M, et al. Whole body imaging in blunt multisystem trauma patients without obvious signs of injury: results of a prospective study. Arch Surg. 2006;141:468–473
  29. Brink M, Deunk J, Dekker HM, et al. Added value of routine chest MDCT after blunt trauma: evaluation of additional findings and impact on patient management. AJR Am J Roentgenol. 2008;190:1591–1598
  30. Shackford SR, Rogers FB, Osler TM, et al. Focused abdominal sonogram for trauma: the learning curve of nonradiologist clinicians in detecting hemoperitoneum. J Trauma. 1999;46:553–562
  31. Blackmore CC, Zweibel A, Mann FA. Determining risk of traumatic aortic injury: how to optimize imaging strategy. AJR Am J Roentgenol. 2000;174:343–347
  32. Kirkham JR, Blackmore CC. Screening for aortic injury with chest radiography and clinical factors. Emerg Radiol. 2007;14:211–217
  33. Tam MM. Occult pneumothorax in trauma patients: should this be sought in the focused assessment with sonography for trauma examination?. Emerg Med Australas. 2005;17:488–493
  34. Wisbach GG, Sise MJ, Sack DI, et al. What is the role of chest x-ray in the initial assessment of stable trauma patients?. J Trauma. 2007;62:74–78
  35. Katyal D, McLellan BA, Brenneman FD, et al. Lateral impact motor vehicle collisions: significant cause of blunt traumatic rupture of the thoracic aorta. J Trauma. 1997;42:769–772
  36. Dillard E, Luchette FA, Sears BW, et al. Clinician vs mathematical statistical models: which is better at predicting an abnormal chest radiograph finding in injured patients?. Am J Emerg Med. 2007;25:823–830
  37. Sears BW, Luchette FA, Esposito TJ, et al. Old fashion clinical judgment in the era of protocols: is mandatory chest x-ray necessary in injured patients?. J Trauma. 2005;59:324–330
  38. Gittelman MA, Gonzalez-del-Rey J, Brody AS, et al. Clinical predictors for the selective use of chest radiographs in pediatric blunt trauma evaluations. J Trauma. 2003;55:670–676
  39. Rodriguez RM, Hendey GW, Marek G, et al. A pilot study to derive clinical variables for selective chest radioGraphy in blunt trauma patients. Ann Emerg Med. 2006;47:415–418
  40. Appropriateness criteria — rib fractures. Available from: http://acsearch.acr.org/VariantList.aspx?topicid = 30641[accessed 02.09.08]
  41. Sirmali M, Turut H, Topcu S, et al. A comprehensive analysis of traumatic rib fractures: morbidity, mortality and management. Eur J Cardiothorac Surg. 2003;24:133–138

PII: S0009-9260(08)00391-7

doi: 10.1016/j.crad.2008.09.004

Clinical Radiology
Volume 64, Issue 3 , Pages 272-283 , March 2009

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