Purpose
To assess the feasibility and reproducibility of CEUS in the study of low-energy abdominal trauma compared to baseline-US and MDCT in pediatric patients.
Illustrate the different CEUS patterns and focus on the typical direct and indirect signs.
Discuss advantages,
limits and most common pitfalls of CEUS.
Methods and Materials
The study protocol was approved by the Hospital ethic board and written informed consent was obtained from parents.
From February to October 2012,
127 consecutive patients with history of minor blunt abdominal trauma presented to our Department and were evaluated for study eligibility (Fig. 1).
Vital sign recording,
laboratory tests,
and baseline US to detect free abdominal fluid as a routine trauma protocol,
were performed.
Seven patients were excluded from the study because showed hemoperitoneum at US examination and unstable vital signs and were immediately...
Results
35/127 patients were considered eligible to be included in the study (Fig. 1).
3/35 patients were negative at MDCT examination.
In the remaining 32 patients,
MDCT depicted 35 lesions (left kidney n=11; right kidney n=3; spleen n=9; pancreas n=2; liver n=5). Active bleeding was present in 4 cases,
urinoma in 1.
CEUS identified 30/35 lesions and no lesions in the patients with negative CE-MDCT findings.
CEUS missed 3 active bleedings and the urinoma.
Unenhanced US depicted 9/35 parenchimal lesions.
Thus,
the diagnostic performance of CEUS...
Conclusion
CEUS is more sensitive and accurate than baseline-US and almost as sensitive as CT in the identification and characterization of blunt abdominal trauma.
According to ALARA’s criteria,
our data suggest that CEUS should be considered as a useful tool in the assessment and monitoring of blunt abdominal trauma in children.
Moreover this examination can be performed at the patient’s bedside,
without moving the traumatized child to the CT section,
representing a useful alternative to CT in the follow-up of hospedilized children with a known abdominal...
References
1.
Greenspan L,
McLellan BA,
Greig H.
Abbreviated injury scale and injury severity score: a scoring chart.
J Trauma 1985;25:60-64
2.
Moore EE,
Cogbill TH,
Melangoni MA,
et al.
Organ injury scaling.
Surg Clin North Am 1995;75:293-303
3.
Gavant ML,
Schurr M,
Flick PA,
et al.
Predicting clinical outcome of non surgical management of blunt splenic injury: using CT to reveal abnormalities of splenic vasculature.
AJR Am J Roentgenol 1997;168:207-212
4.
McGahan JP,
Wang L,
Richards JR.
From the RSNA refresher courses: focused abdominal US...
Personal Information
V.
Miele1,
V.
Di Giacomo1,
I.
Di Giampietro1,
S.
Ianniello1,
G.
Menichini2,
B.
sessa2,
M.
Trinci3; 1Rome/IT,
2Roma/IT,
3Roma,
ITALY/IT
Mail to: Dr.ssa Guendalina Menichini (
[email protected])