title: Diagnostic value of a hand-carried ultrasound device for free intra-abdominal fluid and organ lacerations in major trauma patients.
abstract: BACKGROUND
  Technological progress has led to the introduction of hand-carried ultrasound (HCU) imagers in clinical workflow. The aim of this study is to analyse whether examination with a HCU device is a rapid and reliable alternative to contrast-enhanced multidetector CT (MDCT) scans in diagnosis of free intra-abdominal fluid and organ lacerations in major trauma patients.
  
  
  METHODS
  31 major trauma patients with an injury severity score >15 and the necessity of a MDCT scan (standard of reference) were enrolled prospectively to this study, and additionally examined with a HCU, according to 'focused assessment with sonography for trauma' principles for the assessment of organ lacerations and free intra-abdominal fluid. The HCU device employed was of the latest generation. Statistical analysis was performed using PASW V.18.
  
  
  RESULTS
  Four patients were diagnosed with free intra-abdominal fluid (prevalence 12.9%). HCU showed a sensitivity and specificity of 75% and 100%, respectively. Positive predictive value and negative predictive value were 100% and 96%, respectively. Five patients had organ lacerations (prevalence 16.1%). In these cases, the HCU was able to detect organ lacerations with a sensitivity and specificity of 80% and 100%, respectively. Therefore, a positive predictive value and negative predictive value of 100% and 96%, respectively, were calculated.
  
  
  CONCLUSIONS
  In major trauma patients, examination with HCU according to the 'focused assessment with sonography for trauma' principles for the diagnosis of organ lacerations and free intra-abdominal fluid is a reliable and rapid alternative to MDCT scans and can help save precious time in emergency situations, and should, additionally, be evaluated in the pre-clinical workflow.
authors.affiliation: Department of Radiology, University Medical Center Regensburg, Franz-Josef-Strauss-Allee 11, Regensburg 93053, Germany. stephan.schleder@ukr.de
authors.forename: Stephan
authors.initials: S
authors.lastname: Schleder
authors.forename: Lena-Marie
authors.initials: LM
authors.lastname: Dendl
authors.forename: Antonio
authors.initials: A
authors.lastname: Ernstberger
authors.forename: Michael
authors.initials: M
authors.lastname: Nerlich
authors.forename: Patrick
authors.initials: P
authors.lastname: Hoffstetter
authors.forename: Ernst-Michael
authors.initials: EM
authors.lastname: Jung
authors.forename: Peter
authors.initials: P
authors.lastname: Heiss
authors.forename: Christian
authors.initials: C
authors.lastname: Stroszczynski
authors.forename: Andreas G
authors.initials: AG
authors.lastname: Schreyer
mesh_terms: D000007:Abdominal Injuries / Q000000981:diagnostic imaging*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D004867:Equipment Design; D006801:Humans; D015601:Injury Severity Score; D007472:Iohexol / Q000031:analogs & derivatives; D022125:Lacerations / Q000000981:diagnostic imaging*; D008875:Middle Aged; D010490:Pericardial Effusion / Q000000981:diagnostic imaging*; D019095:Point-of-Care Systems; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography / Q000295:instrumentation*
chemical_list: D003287:Contrast Media; D007472:Iohexol; C038192:iopromide