Contrast-enhanced ultrasonography in blunt abdominal trauma: considerations after 5 years of experience.
OBJECTIVE
The aim of the study was to evaluate the diagnostic capability of contrast-enhanced ultrasonography (CEUS) in a large series of patients with blunt abdominal trauma.


METHODS
We studied 133 haemodynamically stable patients with blunt abdominal trauma. Patients were assessed by ultrasonography (US), CEUS and multislice computed tomography (MSCT) with and without administration of a contrast agent. The study was approved by our hospital ethics committee (clinical study no. 1/2004/O).


RESULTS
In the 133 selected patients, CT identified 84 lesions; namely, 48 splenic, 21 hepatic, 13 renal or adrenal and two pancreatic. US identified free fluid or parenchymal alterations in 59/84 patients with positive CT and free fluid in 20/49 patients with negative CT. CEUS detected 81/84 traumatic lesions identified on CT and ruled out traumatic lesions in 48/49 patients with negative CT. The sensitivity, specificity and positive and negative predictive values of US were 70.2%, 59.2%, 74.7% and 53.7%, respectively, whereas those of CEUS were 96.4%, 98%, 98.8% and 94.1%, respectively.


CONCLUSIONS
Our study showed that CEUS is an accurate technique for evaluating traumatic lesions of solid abdominal organs. The technique is able to detect active bleeding and vascular lesions, avoids exposure to ionising radiation and is useful for monitoring patients undergoing conservative treatment.
U.O. Radiologia, Policlinico S. Orsola-Malpighi, Bologna, Italy. massimo.valentino@aosp.bo.it
M
M
Valentino
L
L
Ansaloni
F
F
Catena
P
P
Pavlica
A D
AD
Pinna
L
L
Barozzi
D000007:Abdominal Injuries / Q000000981:diagnostic imaging*; D000311:Adrenal Glands / Q000000981:diagnostic imaging / Q000293:injuries; D000328:Adult; D003287:Contrast Media; D005260:Female; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging / Q000293:injuries; D008099:Liver / Q000000981:diagnostic imaging / Q000293:injuries; D008297:Male; D010179:Pancreas / Q000000981:diagnostic imaging / Q000293:injuries; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013154:Spleen / Q000000981:diagnostic imaging / Q000293:injuries; D014057:Tomography, X-Ray Computed / Q000379:methods; D018084:Ultrasonography, Interventional / Q000379:methods*; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging*
D003287:Contrast Media