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首页> 外文期刊>Injury >Primary pan-computed tomography for blunt multiple trauma: can the whole be better than its parts?
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Primary pan-computed tomography for blunt multiple trauma: can the whole be better than its parts?

机译：适用于钝性多发性创伤的主要全盘断层扫描：整体能否比其部分更好？

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Single-pass, whole-body computed tomography (pan-CT) was proposed in the late 1990 s as a new concept for the diagnostic work-up of severely injured patients. Since its introduction, it has led to considerable debate among clinicians and scientists, triggered by concerns about its immediate safety, questionable therapeutic advantages and exposure to radiation. However, it was recently shown that pan-CT scanning may be associated with a reduction in trauma mortality. In this article, we provide an overview of current knowledge of the value of this compelling concept. The diagnostic accuracy of multidetector row CT (MDCT) for clearing various anatomical regions in trauma patients is, at best, unclear. Little is known about the accuracy of pan-CT as a whole, which weakens statements about its effectiveness and prevents inferences about survival advantages. This last point may be explained by a stage-migration or "Will Rogers" phenomenon: Pan-CT increases injury severity by detecting lesions that would not have been recognized by conventional methods but still do not affect treatment decisions, thus artificially lowering the ratio of observed to expected deaths. In order to maintain the credibility of pan-CT technology for trauma, a rigorous, large-scale evaluation of its accuracy is required. Such an evaluation requires consensus about the definition of true and false positive and negative findings in the setting of blunt multiple trauma. In addition, triage criteria need to be refined to increase specificity and reduce the number of unnecessary scans.
机译：在1990年代后期提出了单次通过全身计算机断层扫描（pan-CT），作为诊断严重受伤患者的新方法。自从问世以来，由于对它的直接安全性，可疑的治疗优势和暴露于放射线的担忧，引起了临床医生和科学家之间的广泛争论。然而，最近显示泛CT扫描可能与减少创伤死亡率有关。在本文中，我们概述了此引人入胜概念的价值的最新知识。最多还不清楚多排螺旋CT（MDCT）清除创伤患者各种解剖区域的诊断准确性。对于泛CT整体的准确性知之甚少，这削弱了其有效性的陈述并阻止了对生存优势的推断。最后一点可以通过阶段迁移或“ Will Rogers”现象来解释：Pan-CT通过检测传统方法无法识别但仍不影响治疗决策的病变来增加损伤的严重程度，从而人为地降低了观察到预期死亡。为了保持泛CT技术在创伤方面的信誉，需要对其准确性进行严格的大规模评估。这样的评估需要就钝性多发性创伤中对真假阳性和假阴性结果的定义达成共识。此外，需要完善分类标准，以提高特异性并减少不必要的扫描次数。

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