The prevalence of incidental findings in computed tomography of the head in Pediatric Emergency Department
DOI:
https://doi.org/10.15584/ejcem.2024.2.5Keywords:
head CT incidental findings, pediatric ED, pediatric head CTAbstract
Introduction and aim. Computed tomography (CT) is the first imaging modality in the evaluation of children in case of patients with head injury in pediatric Emergency Departments (EDs). Radiological CT reports include not only lesions that are the main cause of the child’s complaints but also incidental findings. The objective of this study is to assess incidental findings observed in children who were admitted to the ED and had the head CT performed.
Material and methods. This retrospective, cross-sectional study enrolled 644 children under the age of 18, from 1st January 2021 to 31st June 2021. Each child could have had one or more incidental findings in CT
Results. Among all CT studies, incidental findings were found in 279 out of 644 (43.32%) cases, of which 73 (11.34%) had both lesions detected incidentally and related to the trauma.
Conclusion. Head CT is an incredibly useful tool in the assessment of some head emergencies. However, evaluation of the prevalence of incidental findings is difficult. Most of them require no specific further investigation. Pediatricians, who order CTs in children, must be prepared to interpret and communicate findings to families and introduce treatment in necessary situations.
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Nishtar T, Ahmad T, Noor N, Muhammad F. Rational use of Computed Tomography Scan head in the Emergency Department of a high volume tertiary care public sector hospital. Pak J Med Sci. 2019;35(2):302-308. doi:10.12669/pjms.35.2.719
Dogan GM. Comparison of the Efficiency of the Paediatric Brain CTs with Trauma and Non-Trauma Related Indications in the Paediatric Emergency Department. Disaster Emerg Med J. 2021;6(2):80-84. doi: 10.5603/DEMJ.A2021.0014
Novoa Ferro M, Santos Armentia E, Silva Priegue N, Jurado Basildo C, Sepúlveda Villegas CA, Del Campo Estepar S. Brain CT requests from emergency department: reality. Radiologia (Engl Ed). 2020;S0033-8338(20):30123-30125. doi: 10.1016/j.rx.2020.08.005
Rogers AJ, Maher CO, Schunk JE, et al. Incidental findings in children with blunt head trauma evaluated with cranial CT scans. Pediatrics. 2013;132(2):e356-e363. doi: 10.1542/peds.2013-0299
Wang X, You JJ. Head CT for nontrauma patients in the emergency department: clinical predictors of abnormal findings. Radiology. 2013;266(3):783-790. doi: 10.1148/radiol.12120732
Ogbole GI, Adeleye AO, Owolabi MO, Olatunji RB, Yusuf BP. Incidental cranial CT findings in head injury patients in a Nigerian tertiary hospital. J Emerg Trauma Shock. 2015;8(2):77-82. doi: 10.4103/0974-2700.155499
Sanei TM, Hemandi H, Sajadi NM, Jalali AH, Eftekharpour D. Evaluation of incidental findings in brain CT scans of mild head trauma patients (GCS: Thirteen to Fifteen). Iran J Cancer Prev. 2010;3:32-35.
Thompson RJ, Wojcik SM, Grant WD, Ko PY. Incidental Findings on CT Scans in the Emergency Department. Emerg Med Int. 2011;2011:624847. doi: 10.1155/2011/624847
Gonçalves FG, Caschera L, Teixeira SR, et al. Intracranial calcifications in childhood: Part 1. Pediatr Radiol. 2020;50(10):1424-1447. doi: 10.1007/s00247-020-04721-1
Go JL, Zee CS. Unique CT imaging advantages. Hemorrhage and calcification. Neuroimaging Clin N Am. 1998;8(3):541-558.
Al Hajri F, Sirasanagandla SR, Boudaka A, Al Dhuhli H, Al Ajmi E. Physiological Intracranial Calcifications in Children: A computed tomography-based study. Sultan Qaboos Univ Med J. 2023;23(2):227-232. doi: 10.18295/squmj.9.2022.058
Kıroğlu Y, Callı C, Karabulut N, Oncel C. Intracranial calcifications on CT. Diagn Interv Radiol. 2010;16(4):263-269. doi:10.4261/1305-3825.DIR.2626-09.1
Ortega HW, Vander Velden H, Reid S. Incidental findings on computed tomography scans in children with mild head trauma. Clin Pediatr (Phila). 2012;51(9):872-876. doi: 10.1177/0009922812450508
Ghimire P, Paudel N, Koirala D. Incidental Findings in CT scan in Pediatric Populations with head injury. Journal of Nepalgunj Medical College. 2018;16:45-47. doi: 10.3126/jngmc.v16i1.24228
Soleman J, Kozyrev DA, Ben-Sira L, Constantini S, Roth J. Management of incidental brain tumors in children: a systematic review. Childs Nerv Syst. 2020;36(8):1607-1619. doi: 10.1007/s00381-020-04658-8
Graf WD, Kayyali HR, Abdelmoity AT, Womelduff GL, Williams AR, Morriss MC. Incidental neuroimaging findings in nonacute headache. J Child Neurol. 2010;25(10):1182-1187. doi:10.1177/0883073809353149
Vander Wyst KB, Olson ML, Bailey SS, et al. Communicating incidental and reportable findings from research MRIs: considering factors beyond the findings in an underrepresented pediatric population. BMC Med Res Methodol. 2021;21(1):275. doi: 10.1186/s12874-021-01459-8
Wolf SM. Introduction: the challenge of incidental findings. J Law Med Ethics. 2008;36(2):216-218. doi: 10.1111/j.1748-720X.2008.00265.x
Roane JL, Mio M, Viner J, et al. Incidental Findings Among Youth Participating in Multimodal Imaging Research: Characteristics of Findings and Description of a Management Approach. Front Pediatr. 2022;10:875934. doi: 10.3389/fped.2022.875934
Kim BS, Illes J, Kaplan RT, Reiss A, Atlas SW. Incidental findings on pediatric MR images of the brain. AJNR Am J Neuroradiol. 2002;23(10):1674-1677.
Seki A, Uchiyama H, Fukushi T, Sakura O, Tatsuya K; Japan Children's Study Group. Incidental findings of brain magnetic resonance imaging study in a pediatric cohort in Japan and recommendation for a model management protocol. J Epidemiol. 2010;20, 2(2):498-504. doi: 10.2188/jea.je20090196
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