Cervical spine injury: accuracy of helical CT used as a screening technique |
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Authors: | J A Hanson C C Blackmore F A Mann A J Wilson |
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Institution: | (1) Department of Radiology, Harborview Medical Center, University of Washington School of Medicine, 325 Ninth Ave., Seattle, WA 98104, USA, US;(2) Department of Radiology, Box 359728, Harborview Medical Center, 325 Ninth Ave, Seattle, WA 98104, USA Tel.: + 1-2 06-7 31 35 61, Fax: + 1–206–7318560), US;(3) Department of Radiology, University of North Carolina, Chapel-Hill, NC 27599, USA, US |
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Abstract: | Objective: The study objective was to determine the sensitivity and specificity of a helical CT technique to screen for cervical spine
injury in a high-risk trauma population. Materials and methods: The helical CT reports for a consecutive series of 601 high-risk adult blunt trauma victims were reviewed. Findings were
confirmed using an independent reference standard, which consisted of additional cervical spine imaging (CT, MRI, or radiography),
operative findings, autopsy results or clinical outcome. Results: Sensitivity and specificity of helical CT for injury were 77/81 (95 %; 95 % confidence limits: 90–100 %) and 484/520 (93
%; 95 % confidence limits 91–95 %) respectively. Four false negative cases were comprised of three missed ligamentous injuries
and one missed fracture. False positive cases (n = 36) were mostly attributed to possible facet fracture (n = 6), possible ligamentous injury (n = 8) or technically inadequate scan (n = 6).The overall accuracy of the helical CT protocol for cervical spine injury in this population was 561/601 (93 %; 95 %
confidence limits 91–95 %). Conclusion: Helical CT has high accuracy for cervical spine injury. We believe that helical CT should be the preferred imaging strategy
in high-risk blunt trauma patients. |
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Keywords: | Helical CT – Screening – Cervical spine injury – Spinal fracture – Adult |
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