title: Ultrasonographic diagnosis of abdominal free fluid: accuracy comparison of emergency physicians and radiologists.
abstract: OBJECTIVE
  Blunt abdominal trauma is a diagnostic challenge for emergency physicians and ultrasonography is one of the diagnostic tools used in this type of injuries. The aim of this study was to evaluate the diagnostic value of ultrasonographies performed by emergency physicians and radiologists.
  
  
  METHODS
  This prospective diagnostic study was performed in the emergency departments of two trauma centers in Iran during a period of 12 months. The subjects were all patients with blunt abdominal trauma that were candidated for abdominopelvic computed tomography (CT) scanning in our emergency departments. The results of focused assessment with sonography for trauma (FAST) performed by emergency physicians and radiologists were compared blindly with the results of CT scans performed by radiologists. The sensitivity, specificity, and predictive values of diagnosis for different abdominal anatomic areas were calculated.
  
  
  RESULTS
  In total, 450 patients undergoing FAST and CT scanning were studied. The sensitivity of radiologists' diagnoses for Morison's, splenorenal, perivesical, and pleural effusion areas were, respectively, 88.0, 70.0, 38.0, and 30.0 %. The corresponding values for emergency physicians' diagnoses were, respectively, 82.0, 60.0, 28.0, and 30.0 %. The specificity of radiologists' diagnoses in the mentioned areas were, respectively, 98.9, 100, 93.1, and 100 %, and for emergency physicians, they were, respectively, 98.9, 100, 96.0, and 100 %.
  
  
  CONCLUSIONS
  Emergency physicians showed a promising performance in applying FAST in blunt abdominal trauma. The specificity of ultrasonographic diagnosis in the emergency physicians group and the radiologists group were comparable, while radiologists showed a higher performance regarding the sensitivity of the ultrasonographic diagnosis.
authors.affiliation: Kerman Neuroscience Research Center, Kerman University of Medical Sciences, Kerman, Islamic Republic of Iran. tajadinishahrad@yahoo.com.
authors.forename: S
authors.initials: S
authors.lastname: Tajoddini
authors.affiliation: Tabriz University of Medical Sciences, Tabriz, Islamic Republic of Iran.
authors.forename: S
authors.initials: S
authors.lastname: Shams Vahdati
keywords: Blunt abdominal injury; Emergency medicine; FAST; Focused assessment with sonography for trauma; Ultrasound
references.citation: Ann Emerg Med. 2004 Mar;43(3):354-61
references.pmid: 14985663
references.citation: J Emerg Med. 1984;1(6):547-8
references.pmid: 6444150
references.citation: Am J Emerg Med. 1989 Mar;7(2):209-15
references.pmid: 2645890
references.citation: Ann Emerg Med. 1997 Mar;29(3):380-2
references.pmid: 9055778
references.citation: J Trauma. 2001 Sep;51(3):545-50
references.pmid: 11535908
references.citation: Am J Emerg Med. 1989 Nov;7(6):605-11
references.pmid: 2679578
references.citation: Am Surg. 2001 Apr;67(4):364-8
references.pmid: 11308006
references.citation: J Trauma. 1999 Oct;47(4):632-7
references.pmid: 10528595
references.citation: J Emerg Med. 1984;1(6):549
references.pmid: 6444151
references.citation: J Trauma. 2000 May;48(5):902-6
references.pmid: 10823534
references.citation: Acad Emerg Med. 2003 Jan;10(1):37-42
references.pmid: 12511313
references.citation: J Trauma. 1965 Jan;5:53-61
references.pmid: 14255175
references.citation: J Pediatr Surg. 1998 Feb;33(2):322-8
references.pmid: 9498410
references.citation: J Trauma. 1998 Apr;44(4):604-6; discussion 607-8
references.pmid: 9555830
references.citation: J Ultrasound Med. 1997 Oct;16(10 ):653-62; quiz 663-4
references.pmid: 9323670
references.citation: Radiographics. 2001 Oct;21 Spec No:S191-9
references.pmid: 11598257
references.citation: J Emerg Med. 1998 Jul-Aug;16(4):655-7
references.pmid: 9696189
references.citation: J Emerg Med. 1990 Jul-Aug;8(4):491-2
references.pmid: 2212571
references.citation: J Trauma. 2001 Jan;50(1):108-12
references.pmid: 11231679
references.citation: Int J Emerg Med. 2008 Sep;1(3):183-7
references.pmid: 19384513
references.citation: J Trauma. 1995 Aug;39(2):375-80
references.pmid: 7674411