Incidental findings in pediatric head CT scans are rare but could have serious consequences, according to a study in Pediatrics.
The nationwide U.S. project, part of the federally funded Pediatric Emergency Care Applied Research Network (PECARN), examined the results of trauma head CT in almost 44,000 pediatric patients presenting in 25 hospital emergency rooms.
Among nearly 16,000 CT scans acquired to evaluate injury, 4% showed rare incidental findings that ranged from enlarged tonsils to unexpected malignancies, wrote researchers from the University of Michigan; the University of California, Davis (UCD); and several other centers (Pediatrics, August 2013, Vol. 132:2, pp. e356-e363).
On the positive side, when the researchers grouped the findings into three categories -- those needing immediate evaluation or treatment, those needing timely follow-up, or those possibly needing follow-up if they became symptomatic -- only 0.1% of findings fell into the most serious category.
The study is the largest pediatric multicenter report of the prevalence of incidental findings on head CT scans, and it also represents part of a study aimed at determining when CT is appropriate for head injuries, according to the study team.
Incidental findings are rare but significant, added co-investigator Dr. Nathan Kuppermann, professor and chair of emergency medicine at UCD Medical Center, in a statement. Doctors must look for unexpected abnormalities and be prepared to interpret and explain these findings to patients' families, he said.
