title: Liver trauma diagnosis with contrast-enhanced ultrasound: interobserver variability between radiologist and emergency physician in an animal study.
abstract: OBJECTIVE
  The purpose of our study was to evaluate interobserver variability between the radiologist and emergency physician in detecting blunt liver trauma by conventional and contrast-enhanced ultrasound (US) (CEUS).
  
  
  METHODS
  We created 20 sites of blunt liver trauma in rabbits and performed conventional US and CEUS on the animals. A radiologist and an emergency physician independently evaluated the degree of liver trauma. Using contrast-enhanced computed tomography as a reference standard, the diagnostic performance of US and CEUS was calculated. Interobserver variability between radiologist and emergency physician was compared before and after contrast enhancement of US.
  
  
  RESULTS
  Overall sensitivity and specificity for detecting liver trauma on conventional US, regardless of the degree of trauma, were 61.1% and 100% for the radiologist and 50% and 100% for the emergency physician. On CEUS, the sensitivity and specificity were 94.4% and 100% for both the radiologist and emergency physician. The interobserver agreement between emergency physician and radiologist increased from 0.867 to 0.955 after contrast enhancement on US.
  
  
  CONCLUSIONS
  Contrast-enhanced US may permit a more accurate diagnosis for liver trauma than conventional US by both the radiologist and emergency physician. Contrast-enhanced US may also reduce interobserver variability for this diagnosis.
authors.affiliation: Department of Emergency Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul 120-752, Republic of Korea.
authors.forename: Je Sung
authors.initials: JS
authors.lastname: You
authors.forename: Yong Eun
authors.initials: YE
authors.lastname: Chung
authors.forename: Hye-Jeong
authors.initials: HJ
authors.lastname: Lee
authors.forename: Sung Phil
authors.initials: SP
authors.lastname: Chung
authors.forename: Incheol
authors.initials: I
authors.lastname: Park
authors.forename: Myeong-Jin
authors.initials: MJ
authors.lastname: Kim
authors.forename: Mi-Suk
authors.initials: MS
authors.lastname: Park
authors.forename: Joon Seok
authors.initials: JS
authors.lastname: Lim
authors.forename: Jin-Young
authors.initials: JY
authors.lastname: Choi
authors.forename: Seungho
authors.initials: S
authors.lastname: Kim
authors.forename: Ki Whang
authors.initials: KW
authors.lastname: Kim
mesh_terms: D000818:Animals; D004635:Emergency Medicine; D008099:Liver / Q000000981:diagnostic imaging / Q000293:injuries*; D008297:Male; D015588:Observer Variation; D010820:Physicians; D011817:Rabbits; D011871:Radiology; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging