Incidental findings in brain CT scans of patients with head trauma

Marzieh  Alinezhad; Fariba  Alikhani; Fatemeh  Bamarinejad; Aatefeh  Bamarinejad; Fatemezahra  Hosseinzadeh

doi:10.18502/fem.v8i2.15464

Marzieh Alinezhad Department of Radiology, Isfahan University of Medical Sciences, Isfahan, Iran.
Fariba Alikhani Department of Radiology, Isfahan University of Medical Sciences, Isfahan, Iran.
Fatemeh Bamarinejad School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Aatefeh Bamarinejad School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Fatemezahra Hosseinzadeh School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

DOI: https://doi.org/10.18502/fem.v8i2.15464

Keywords: Computed Tomography; Head Trauma; Incidental Finding

Abstract

Objective: Incidental findings (IFs) are newly discovered abnormal findings unrelated to the primary purpose of imaging. Brain computed tomography (CT) scan is one of the most essential and initial imaging evaluations for head trauma patients, which may also have nontraumatic IFs. We aim to investigate the prevalence and nature of IFs in brain CT scans of head trauma patients.

Methods: We conducted a cross-sectional study to evaluate brain CT scans of 1006 head trauma patients over one year (April 2021 to March 2022), to identify incidental findings by consensus agreement of two radiologists. We categorized the incidental findings into four categories based on appropriate follow-up recommendations.

Results: We included 1006 head trauma patients who underwent brain CT scan, of which 126 incidental findings were discovered in brain CT scan of 107 patients. The prevalence of incidental findings was 10.6% (107/1006). The most common incidental finding was brain atrophy (n=15, 11.9%). The mean age of patients with IFs was significantly higher than those without IFs, but there was no difference between the two groups regarding gender.

Conclusion: The discovery rate of incidental findings of brain CT scans in head trauma patients was considerable. Serious medical findings that need immediate evaluation were found in 5.6% of patients, mostly over the age of 40. Therefore, patients who have clinically significant incidental findings need improved documentation and follow-up to evaluate the long-term outcomes and reliability of imaging results.