@article{ref1,
title="Whole-body CT after motor vehicle crash: no benefit after high-energy impact and with normal physical examination",
journal="Radiology",
year="2019",
author="Belabbas, Dihia and Auger, Magali and Lederlin, Mathieu and Bonenfant, Jérémie and Gandon, Yves and Aubé, Cristophe and Paisant, Anita",
volume="292",
number="1",
pages="94-100",
abstract="Background Debate continues about the risks and benefits of systematic whole-body CT when no injury is clinically suspected. Risks of whole-body CT include high radiation exposure and iodine contrast agent, but its effectiveness in reducing mortality in low-risk motor vehicle crashes is unclear. <br><br>PURPOSE To assess unsuspected injuries revealed at whole-body CT in patients following motor vehicle crash (MVC) meeting only kinetic elements of the Vittel criteria for the severity of trauma, with no evidence of trunk injury and a Glasgow Coma Scale score of 15. <br><br>MATERIALS AND METHODS This retrospective study included all consecutive adult patients who consulted an emergency department of a level 1 trauma center between August 2016 and July 2017 if they underwent whole-body CT for one or more kinetic elements of the Vittel criteria, had a normal examination of the trunk, and had a Glasgow Coma Scale score of 15. Data of the MVC mechanism and physical and biologic examinations were collected, as well as patient treatment data after whole-body CT. Whole-body CT examinations were read by two double-blinded readers to help detect unsuspected injuries. <br><br>RESULTS Ninety-three patients were included; 72 were men with a mean age of 30.8 years ± 12.0 (standard deviation). Sixty-nine patients were occupants of a car. Seventeen patients were hit by a car while on motorbikes, three while on bicycles, and four as pedestrians. Unsuspected injuries were depicted at 11 whole-body CT examinations: eight lung contusions, one acetabular fracture, one sternal fracture, and one adrenal hematoma. None of these injuries required a specific treatment. One patient with lung contusion of more than 30% of lung volume was followed without requiring further treatment. <br><br>CONCLUSION In this population, whole-body CT did not lead to any change in patient treatment. These results suggest whole-body CT should not be systematically performed when no evidence of trunk injury is observed in patients following motor vehicle crash meeting only kinetic elements of Vittel criteria. © RSNA, 2019 See also the editorial by Munera and Durso in this issue.<p /> <p>Language: en</p>",
language="en",
issn="0033-8419",
doi="10.1148/radiol.2019182806",
url="http://dx.doi.org/10.1148/radiol.2019182806"
}