Influence of medical speciality and experience on interpretation of helicoidal thoracic computed tomography in blunt chest trauma.
OBJECTIVE
To compare the quality of interpretation of chest helicoidal computed tomography (HCT) by physicians with different levels of experience and medical specialty.


METHODS
Prospective observational study.


METHODS
Trauma critical care unit at a French university hospital (US equivalent: level 1).


METHODS
HCT of 50 consecutive patients with blunt chest trauma were assessed by four groups of physicians [residents in anaesthesiology (n=5), residents in radiology (n=5), senior anaesthesiologists (n=5), and senior radiologists (n=5)]. Interpretation from each physician was compared with a grid obtained from an expert interpretation by a senior radiologist and a senior anaesthesiologist.


METHODS
None.


RESULTS
No group of observers performed better than another in their interpretation of lung and parietal injuries on HCT. In contrast, senior radiologists were better than anaesthesiologists for the diagnosis of pneumomediastin. However, residents in radiology performed better than other physicians in detecting the presence of gastric and tracheal tubes.


CONCLUSIONS
Compared with anaesthesiologists, senior radiologists seem more expert in the diagnosis of HCT mediastinal injuries whereas residents in radiology were better at detecting resuscitation materials in thoracic trauma patients. This article reinforces the usefulness of the interpretation of the HCT by a senior radiologist in the case of blunt chest trauma. This also reinforces the usefulness of an aspect team of radiologists and anaesthesiologists in the case of trauma. The logical usefulness of a systematic interpretation of the images should be borne in mind.
Compère
V
V
Department of Anaesthesiology and Critical Care, Charles Nicolle University Hospital, CHU-Hôpitaux de Rouen 1, rue de Germont, 76031 Rouen, France.
Genevois
A
A
Le Corre
A
A
Hellot
M F
MF
Bourguignon
N
N
Vandelet
P
P
Veber
B
B
Dureuil
B
B
D000293:Adolescent; D000328:Adult; D000368:Aged; D003951:Diagnostic Errors; D005260:Female; D006801:Humans; D008297:Male; D008511:Medicine; D008875:Middle Aged; D011446:Prospective Studies; D013038:Specialization; D013898:Thoracic Injuries / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000453:epidemiology; D036542:Tomography, Spiral Computed; D014949:Wounds, Nonpenetrating / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000453:epidemiology