Incidental findings identified by universal screening for BCVI using CT angiography

Area of Science:

• Trauma surgery
• Vascular imaging
• Diagnostic radiology

Background:

• Blunt cerebrovascular injuries (BCVIs) affect carotid or vertebral arteries after blunt trauma.
• Neck computed tomographic angiography (CTA) is standard for BCVI screening.
• Universal screening protocols are increasingly adopted to minimize missed injuries.

Purpose of the Study:

• To determine the incidence of incidental findings (IFs) discovered during universal screening for BCVI.
• To assess the rate of IFs in blunt trauma patients undergoing neck CTA.

Main Methods:

• Retrospective review of medical records for adult blunt trauma patients (Priority 1 and 2) from April 2023 to April 2024.
• Analysis of patients screened with neck CTA for BCVI.
• Identification and categorization of incidental findings.

Main Results:

• 1,554 patients underwent neck CTA screening; 58 (3.73%) had BCVI.
• 265 IFs were found in 224 patients (14.55%), including arterial occlusions, aneurysms, stenoses, and thyroid nodules.
• 36.16% of patients with IFs were discharged without documented notification.

Conclusions:

• Incidental findings are common in blunt trauma patients screened universally for BCVI.
• Trauma centers must establish protocols for patient notification of IFs to ensure appropriate follow-up care.
• Effective management of IFs is crucial for comprehensive patient care post-trauma.