Purpose
The aim of the study is to evaluate the sensibility of contrast-enhanced ultrasound (CEUS) in the detection and staging of abdominal traumatic lesions in patients with low-energy isolated abdominal trauma in comparison with baseline ultrasound (US) and contrast-enhanced computed tomography (CE-MDCT),
considered the gold standard.
The management of patients with mild or low-energy trauma is still the subject of controversy.
CT examination is the most accurate and panoramic imaging tool in the evaluation of patients involved in a high-energy accident in stable condition [1-3].
Baseline...
Methods and Materials
PATIENTS
Between January 2010 and December 2012 a total of 352 consecutive patients who arrived in our Emergency Department with an history of low-energy isolated abdominal trauma and in stable haemodynamic conditions were analyzed (224 males; 128 females - mean age 27±2.8 years).
The major causes of blunt abdominal trauma are reported in Table 1.
All patients underwent US and CEUS with the use of a second-generation contrast agent (Sonovue,
Bracco-Milan,
Italy).
Written informed consent was obtained from all the patients or from their relatives...
Results
In the 352 Patients included in the study CE-MDCT identified 74 Patients with abdominal positive findings (20%),
with a total of 83 traumatic lesions due to the presence of two lesions in 9 patients (liver= n 30,
spleen= n 35,
Kidney= n 18),
with a diameter range of 1 to 10 cm.
On the basis of CE-MDCT findings,
considered as the reference standard,
we analyze the capacity of US and CEUS to identify the number oftraumatic lesions.
US depicted 45/83 traumatic intraparenchymal lesions (liver= 19/30,...
Conclusion
In patients with low-energy isolated abdominal trauma conventional US has a low sensibility in the identification of organ injuries and so it should be replaced by CEUS as the first line approach.
CEUS has shown an high sensibility both in the detection and grading of traumatic lesions.
CEUS negative patients with history of blunt abdominal trauma and without clinical symptoms or laboratory alteration tests,
after a period of observation,
may be discharged home,
without undergoing CT examination.
In patient with CEUS positive findings CE-MDCT must...
References
Valentino M,
Ansaloni L,
Catena F et al.Contrast-enhanced ultrasonography in blunt abdominal trauma: considerations after 5 years of experience.
Radiol Med 114: 1080-1093,
2009.
Miele V,
Buffa V,
Stasolla A et al.
Ecografia con mdc di seconda generazione nelle lesioni traumatiche del fegato.
Radiol Med 107: 82-91,
2004.
Catalano O,
Aiani L,
Barozzi L et al.CEUS in abdominal trauma: multy-center study.
Abdominal Imaging 34:225-234,
2009.
Clevert D.A,
Weckbach S,
Minaifar N et al.
Contrast-enhanced ultrasound versus MS-CT in blunt abdominal trauma.
Clin Hemorheology and Microcirculation...
Personal Information
Authors:
Vittorio Miele MD
Vincenza Di Giacomo MD
Ilenia Di Giampietro MD
Stefania Ianniello MD
Guendalina Menichini MD
Barbara Sessa MD
Margherita Trinci MD
E-mail to Barbara Sessa MD:
[email protected]