Retrospective analysis of head computed tomography investigations ordered by emergency department: comparison of clinical pre-diagnosis and radiologic results

Öz

INTRODUCTION: Medical imaging, especially computed tomography (CT) utilization in emergency departments has increased in recent years. This leads to increase in total radiation dose per patient. To prevent unnecessary CT investigations, first we need to understand the dynamics between pre-diagnosis and radiologic results. Head CT is the most ordered CT investigation in emergency departments. In this study, we aimed to evaluate the relation between pre-diagnosis and radiologic results of head CT investigations. METHODS: Retrospective analyze of head CT radiologic final reports and patients’ clinical records between 5 June 2019 and 5 September 2019 in emergency department was performed. Patients’ clinical records were used the define the pre-diagnosis leading to order head CT in the emergency department admittance. RESULTS: Totally 2249 head CT investigations of 2039 patients were performed in defined time period at emergency radiology department. “Trauma” was the most frequent pre-diagnosis with 37% for ordering head CT in emergency department. In this group, radiologic results of head CTs were as fallow; 69% normal, 14% fracture and 7% hemorrhage. In syncope, headache and vertigo pre-diagnosis groups radiologic final diagnosis was normal in up to 95%. DISCUSSION AND CONCLUSION: In this study, the most of the head CT investigations ordered by emergency department found to be normal. The reason for this high rate of normal results might be related with the high power of head CT to exclude acute pathology and emergency department doctors need to rule out acute pathology quickly.

Anahtar Kelimeler

• emergency room
• multidetector computed tomography
• head trauma

Acil servisten istenen beyin BT tetkiklerinin retrospektif analizi: klinik ön tanı ve sonuç karşılaştırması

Öz

GİRİŞ ve AMAÇ: Son yıllarda acil servislerde başta bilgisayarlı tomografi (BT) olmak üzere medikal görüntüleme yöntemlerinin kullanımı oldukça artmıştır. Ancak artan BT kullanımı hasta başına düşen total radyasyon dozunun da artmasına neden olmaktadır. Gereksiz radyolojik tetkiklerin kontrol altına alınması ise cihazların etkin kullanımı ve radyolojik tetkik istem-sonuç ilişkisinin anlaşılması ile mümkündür. Acil servislerde en sık elde olunan BT tetkiki ise beyin BT incelemesidir. Bu çalışma ile acil servisten istenen beyin BT tetkiklerinin ön tanı-radyolojik sonuç dağılımın araştırılması amaçlanmıştır. YÖNTEM ve GEREÇLER: Üniversite hastanemizin acil servisine hizmet veren acil radyoloji departmanında 5 Haziran 2019 - 5 Eylül 2019 tarihleri arasındaki üç aylık süreçte elde olunan beyin BT incelemelerinin raporları ve ilgili hasta dosyaları, klinik ön tanı ve radyolojik sonuç açısından retrospektif olarak analiz edilmiştir. BULGULAR: 5 Haziran 2019- 5 Eylül 2019 tarihleri arasında, acil radyoloji departmanında 2039 adet hastaya ait 2249 adet beyin BT tetkiki elde olunmuştur. En sik beyin BT istem sebebi travmadır (%37). Travma on tanisi ile gelen hastalarin %69’si normal, %14’ü fraktur ve %7’si kanama olarak raporlanmistir. SVO ön tanısı ile gelen hastaların ise %63’si normal, %28’i enfarkt, %5’i kitle olarak raporlanmıştır. Senkop, baş ağrısı ve baş dönmesi ön tanıları %95’lere varan normal radyolojik son tanı oranlarına sahiptir. TARTIŞMA ve SONUÇ: Bu çalışma sonucunda; acil BT tetkikleri arasında en sık uygulanan beyin BT incelemesi büyük oranda normal bulunmuş olup bu modalitenin sıklıkla olası patolojiyi dışlamak amacıyla istendiği düşünülmüştür.

Anahtar Kelimeler

• acil servis
• multidedektör bilgisayarlı tomografi
• kafa travması

Kaynakça

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