The efficacy of ultrasonography in hemodynamically stable children with blunt abdominal trauma: a prospective comparison with computed tomography.
OBJECTIVE
In this prospective study we aimed to investigate the diagnostic value of ultrasonography (US) in hemodynamically stable children after blunt abdominal trauma (BAT) using computed tomography (CT) as the gold standard.


METHODS
Between 1997 and 2001, 96 children with BAT were evaluated prospectively. CT was performed first, followed by US. US and CT examinations were independently evaluated by two radiologists for free fluid and organ injury. The sensitivity, specificity, positive predictive value, negative predictive value and overall accuracy of US were assessed regarding CT as the gold standard.


RESULTS
Overall 128 organ injuries were determined in 96 patients with CT; however, 20 (15.6%) of them could not be seen with US. Free intraabdominal fluid (FIF) was seen in 82 of 96 patients by CT (85.4%) and eight of them (9.7%) could not be seen by US. We found that sensitivity, specificity, positive predictive value, negative predictive value and overall accuracy of the US for free intra-abdominal fluid were 90.2, 100, 100, 63.6 and 91.7%, respectively.


CONCLUSIONS
US for BAT in children is highly accurate and specific. It is highly sensitive in detecting liver, spleen and kidney injuries whereas its sensitivity is moderate for the detection of gastrointestinal tract (GIT) and pancreatic injuries.
Taş
Fikret
F
Department of Radiology, Faculty of Medicine, Cumhuriyet University, 58140 Sivas, Turkey. ftas@cumhuriyet.edu.tr
Ceran
Canan
C
Atalar
Mehmet H
MH
Bulut
Sema
S
Selbeş
Bilge
B
Işik
A Oktay
AO
D000007:Abdominal Injuries / Q000000981:diagnostic imaging*; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging*