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Head trauma is a frequent reason for consultation in the emergency room. The CT scan is the reference examination allowing rapid management of the patient. However, CT examinations are among the diagnostic examinations with the highest exposure to ionizing radiation. The study investigators have previously implemented "ultra-low dose" (ULD) acquisitions for several pathologies with an effective dose level similar to that of a standard radiographic examination. These ULD acquisitions are now routinely used in our clinical practice for explorations of the thorax, spine, pelvis and proximal femurs, extremities.
This study expands these ULD acquisitions to skull CT for detecting traumatic intracranial lesions.
The study investigators hypothesize that it would be possible to search for intracranial lesions in patients with head trauma using ULD protocols, thereby reducing the doses delivered to the patient while maintaining sufficient image quality for the diagnosis.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Patients with head trauma | Experimental |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| CT scan | Diagnostic Test | Scan with classic dose followed by ultra-low dose |
|
| Measure | Description | Time Frame |
|---|---|---|
| Image quality of ultra-low dose scan compared to classic dose for visualising the differentiation of grey/white matter | 5-point scale: unacceptable, sub-optimal, acceptable, better than average | Day 0 |
| Image quality of ultra-low dose scan compared to classic dose for visualising lenticular nuclei | 5-point scale: unacceptable, sub-optimal, acceptable, better than average | Day 0 |
| Image quality of ultra-low dose scan compared to classic dose for visualising the ventricular system | 5-point scale: unacceptable, sub-optimal, acceptable, better than average | Day 0 |
| Image quality of ultra-low dose scan compared to classic dose for visualising basal cisterns | 5-point scale: unacceptable, sub-optimal, acceptable, better than average | Day 0 |
| Image quality of ultra-low dose scan compared to classic dose for visualising deconvexed subarachnoid spaces | 5-point scale: unacceptable, sub-optimal, acceptable, better than average | Day 0 |
| Measure | Description | Time Frame |
|---|---|---|
| Inter-evaluator concordance (senior versus junior) in visualizing all five structures (differentiation of grey/white matter, lenticular nuclei, ventricular system, basal cisterns, deconvexed subarachnoid spaces) | Total score of the 5 Likert scores | Day 0 |
| Presence of at least one extradural hematoma by ultra-low dose versus classical scanner |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Nicolas Menjot de Champfleur | CHU Nimes | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| CHU de Nimes | Nîmes | France |
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Yes/no |
| Day 0 |
| Presence of at least one subarachnoid hemorrhage by ultra-low dose versus classical scanner | Yes/no | Day 0 |
| Presence of at least one subdural hematoma by ultra-low dose versus classical scanner | Yes/no | Day 0 |
| Presence of at least one intraparenchymal hemorrhage by ultra-low dose versus classical scanner | Yes/no | Day 0 |
| Presence of at least one intracranial hemorrhage by ultra-low dose versus classical scanner | Yes/no | Day 0 |
| Presence of at least one cranial bone lesion by ultra-low dose versus classical scanner | Yes/no | Day 0 |
| Presence of at least one bone lesion by ultra-low dose versus classical scanner | Yes/no | Day 0 |
| Radiologist-reported image quality of ultra-low dose versus classical scanner | 4-point Likert scale: Interpretable, interpretable despite moderate technical issues (centering, movement, constant), entirely interpretable despite moderate technical issues (centering, movement, constant), No technical issues | Day 0 |
| Radiologist-reported diagnostic quality of ultra-low dose versus classical scanner | 4-point Likert scale: unacceptable, sub-optimal, acceptable, better than average | Day 0 |
| Radiologist-reported confidence level of ultra-low dose versus classical scanner | 4-point Likert scale: unacceptable, sub-optimal, acceptable, better than average | Day 0 |
| Interpretation time of ultra-low dose versus classical scanner for a senior and junior evaluator | Minutes | Day 0 |
| ID | Term |
|---|---|
| D016489 | Head Injuries, Closed |
| D020197 | Head Injuries, Penetrating |
| ID | Term |
|---|---|
| D006259 | Craniocerebral Trauma |
| D020196 | Trauma, Nervous System |
| D009422 | Nervous System Diseases |
| D014947 | Wounds and Injuries |
| D014949 | Wounds, Nonpenetrating |
| D014950 | Wounds, Penetrating |
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| ID | Term |
|---|---|
| D014057 | Tomography, X-Ray Computed |
| ID | Term |
|---|---|
| D007090 | Image Interpretation, Computer-Assisted |
| D003952 | Diagnostic Imaging |
| D019937 | Diagnostic Techniques and Procedures |
| D003933 | Diagnosis |
| D011856 | Radiographic Image Enhancement |
| D007089 | Image Enhancement |
| D010781 | Photography |
| D011859 | Radiography |
| D014056 | Tomography, X-Ray |
| D014054 | Tomography |
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