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Contrast-enhanced ultrasonography in blunt abdominal trauma: considerations after 5 years of experience

L’ecografia con mezzo di contrasto nei traumi chiusi dell’addome: considerazioni dopo 5 anni di esperienza

  • Abdominal Radiology / Radiologia Addominale
  • Published:
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Abstract

Purpose

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.

Materials and 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.

Riassunto

Obiettivo

Scopo di questo lavoro è stato valutare le possibilità diagnostiche dell’ecografia con mezzo di contrasto (CEUS) in un’ampia serie di pazienti con trauma chiuso dell’addome.

Materiali e metodi

Sono stati studiati 133 pazienti con trauma addominale chiuso, emodinamicamente stabili. I pazienti sono stati valutati con ecografia (US), CEUS e tomografia computerizzata (TC) multistrato senza e con mezzo di contrasto (MdC). Lo studio è stato approvato dal comitato etico dell’Ospedale (studio clinico no1/2004/O).

Risultati

Nei 133 pazienti la TC ha identificato 84 lesioni, 48 spleniche, 21 epatiche, 13 renali o surrenaliche e 2 pancreatiche. L’US ha identificato versamento libero o alterazioni parenchimali in 59/84 pazienti positivi alla TC e versamento libero in 20/49 pazienti negativi alla TC. La CEUS ha riconosciuto 81/84 lesioni traumatiche identificate dalla TC e ha escluso lesioni traumatiche in 48/49 pazienti negativi alla TC. Sensibilità, specificità, valore predittivo positivo e negativo per l’US sono stati rispettivamente 70,2%, 59,2%, 74,7% e 53,7%; per la CEUS sono stati 96,4%, 98%, 98,8% e 94,1%.

Conclusioni

Lo studio ha dimostrato che la CEUS è uno strumento accurato nella valutazione delle lesioni traumatiche degli organi solidi addominali. La metodica riconosce il sanguinamento attivo e le lesioni vascolari, evita l’esposizione a radiazioni ionizzanti ed è utile nel monitoraggio dei pazienti con trattamento conservativo.

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Authors and Affiliations

  1. U.O. Radiologia, Policlinico S. Orsola-Malpighi, Via Massarenti 9, 40138, Bologna, Italy

    M. Valentino, P. Pavlica & L. Barozzi

  2. U.O. Chirurgia, Policlinico S. Orsola-Malpighi, Via Massarenti 9, 40138, Bologna, Italy

    L. Ansaloni, F. Catena & A. D. Pinna

Authors
  1. M. Valentino
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  2. L. Ansaloni
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  3. F. Catena
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  4. P. Pavlica
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  5. A. D. Pinna
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  6. L. Barozzi
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Correspondence to M. Valentino.

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Valentino, M., Ansaloni, L., Catena, F. et al. Contrast-enhanced ultrasonography in blunt abdominal trauma: considerations after 5 years of experience. Radiol med 114, 1080–1093 (2009). https://doi.org/10.1007/s11547-009-0444-0

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  • DOI: https://doi.org/10.1007/s11547-009-0444-0

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