Type:
Educational Exhibit
Keywords:
Not applicable, Trauma, Radiation safety, Diagnostic procedure, Complications, Ultrasound, CT, Paediatric, Abdomen
Authors:
M. Costilla Frías, V. P. Beltrán Salazar, C. Martin Martinez, I. Artacho Rodríguez, I. Romero Novo, N. brun lozano, E. Casanovas Navarro, A. Framis Utset; Sabadell/ES
DOI:
10.26044/ecr2020/C-06211
Background
Blunt abdominal trauma represents one of the principal causes of morbi-mortality in children. Some particular anatomic features (e.g., a thinner abdominal wall, less intraabdominal fat, and a lower position and distance of the organs to the abdominal wall) make severe injuries from a low energy impact more likely in children.
The most widely used abdominal ultrasound technique in polytrauma patients, Focused Assessment with Sonography for Trauma (FAST), has high sensitivity for detecting free abdominal fluid, but low sensitivity for detecting solid-organ injuries [1]. By contrast, multidetector CT is highly sensitive and specific in assessing abdominal injuries [2], but has the drawback of ionizing radiation.
To date, medicine agencies have approved ultrasound contrast agents only for the study of focal liver lesions and vesicoureteral reflux. Nevertheless, clinical evidence in adults suggests it can be useful in the evaluation of intraabdominal solid-organ lesions [3-4]. In the context of paediatric polytrauma, contrast-enhanced ultrasound (CEUS) has proven highly sensitive in the diagnosis and follow-up of solid-organ lesions and has some advantages over multiphasic CT [5].
The use of CEUS in paediatric radiology is growing. Some of its features are (Figure 1) [6]:
All these features make CEUS a very attractive technique for the study of solid organ injuries in paediatric trama.