Emergency real-time contrast-enhanced ultrasonography for detection of solid organ injuries.
BACKGROUND
There is no controversy about the use of CT for detection of internal injuries in patients with high-energy multitrauma. However, in most patients isolated blunt abdominal trauma is mild or moderate and the risk of injury to organs other than the liver, spleen or kidneys is minimal. CT scanning exposes patients to radiation, and may often be avoided if significant damage to these three organs can be visualized by contrast-enhanced ultrasonography (CEUS).


METHODS
In our series SonoVue (Bracco, Milan) and Siemens Acuson Sequoia ultrasound machines were used. Initially patients with injuries detected by CT were examined using CEUS. Subsequently CEUS was used as the first and only modality in patients with mild or moderate blunt abdominal trauma to one flank, provided that they were able to cooperate and were otherwise suitable for US examination.


RESULTS
CEUS was able to sensitively detect lacerations and haematomas in the liver, spleen and kidneys in cooperative patients. CEUS also demonstrated very thin lacerations of the parenchyma of these organs. These results were also found in children.


CONCLUSIONS
In our experience CEUS is an accurate and valuable tool for the detection or exclusion of parenchymal damage to the liver, spleen and kidneys. With the proper organization, standardized dynamic documentation and well-trained sonographers, CEUS may replace CT in many patients with mild to moderate blunt abdominal trauma, thus avoiding unnecessary exposure to radiation in this often young and healthy population.
Thorelius
Lars
L
Imaging Diagnosis Center, Herlev Hospital, Denmark. lars@thorelius.com
D000328:Adult; D002648:Child; D003287:Contrast Media; D004630:Emergencies; D005260:Female; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging* / Q000293:injuries*; D008099:Liver / Q000000981:diagnostic imaging* / Q000293:injuries*; D008297:Male; D010743:Phospholipids; D013154:Spleen / Q000000981:diagnostic imaging* / Q000293:injuries*; D013459:Sulfur Hexafluoride; D014463:Ultrasonography; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging*
D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride