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Emergency real-time contrast-enhanced ultrasonography for detection of solid organ injuries

  • Achieving Optimal Diagnostic Yield Using Real-Time CEUS
  • Published:
European Radiology Supplements

Abstract

Background

There is no controversy about the use of CT for detection of internal injuries in patients with high-energy multitrauma. However, in most patients isolated blunt abdominal trauma is mild or moderate and the risk of injury to organs other than the liver, spleen or kidneys is minimal. CT scanning exposes patients to radiation, and may often be avoided if significant damage to these three organs can be visualized by contrast-enhanced ultrasonography (CEUS).

Materials and Methods

In our series SonoVue (Bracco, Milan) and Siemens Acuson Sequoia ultrasound machines were used. Initially patients with injuries detected by CT were examined using CEUS. Subsequently CEUS was used as the first and only modality in patients with mild or moderate blunt abdominal trauma to one flank, provided that they were able to cooperate and were otherwise suitable for US examination.

Results

CEUS was able to sensitively detect lacerations and haematomas in the liver, spleen and kidneys in cooperative patients. CEUS also demonstrated very thin lacerations of the parenchyma of these organs. These results were also found in children.

Conclusion

In our experience CEUS is an accurate and valuable tool for the detection or exclusion of parenchymal damage to the liver, spleen and kidneys. With the proper organization, standardized dynamic documentation and well-trained sonographers, CEUS may replace CT in many patients with mild to moderate blunt abdominal trauma, thus avoiding unnecessary exposure to radiation in this often young and healthy population.

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References

  1. Stuhlfaut JW, Anderson SW, Soto JA (2007) Blunt abdominal trauma: current imaging techniques and CT findings in patients with solid organ, bowel and mesenteric injury. Semin Ultrasound CT MR 28(2):115–129

    Article  PubMed  Google Scholar 

  2. Shuman WP (1997) CT of blunt abdominal trauma in adults. Radiology 205(82):297–306

    PubMed  CAS  Google Scholar 

  3. Yoshii H, Sato M, Yamamoto S et al (1998) Usefulness and limitations of ultrasonography in the initial evaluation of blunt abdominal trauma. J Trauma 45(1):45–50

    Article  PubMed  CAS  Google Scholar 

  4. Brown MA, Sirlin CB, Hoyt DB, Casola G (2003) Screening ultrasound in blunt abdominal trauma. J Intensive Care Med 18(5):253–260

    Article  PubMed  Google Scholar 

  5. McGahan JP, Richards J, Fogata ML (2004) Emergency ultrasound in trauma patients. Radiol Clin North Am 42(2):417–425

    Article  PubMed  Google Scholar 

  6. Stengel D, Bauwens K, Porzsolt F et al (2003) Emergency ultrasound for blunt abdominal trauma-meta-analysis update 2003. Zentralbl Chir 128(12):1027–1037

    Article  PubMed  CAS  Google Scholar 

  7. Valentino M, Serra C, Zironi G et al (2006) Blunt abdominal trauma: emergency contrast-enhanced sonography for detection of solid organ injuries. AJR Am J Roentgenol 186(5):1361–1367

    Article  PubMed  Google Scholar 

  8. McGahan JP, Horton S, Gerescovich EO et al (2006) Appearance of solid organ injury with contrast-enhanced sonography in blunt abdominal trauma: preliminary experience. AJR Am J Roentgenol 187(3):658–666

    Article  PubMed  Google Scholar 

  9. Sparano A, Acampora C, di Nuzzo L et al (2006) Color power Doppler US and contrast-enhanced US features of abdominal solid organ injuries. Emerg Radiol 12(5):216–222

    Article  PubMed  Google Scholar 

  10. Catalano O, Lobianco R, Raso MM, Siani A (2005) Blunt hepatic trauma: evaluation with contrast enhanced sonography: sonographic findings and clinical application. J Ultrasound Med 24(3):299–310

    PubMed  Google Scholar 

  11. Catalano O, Lobianco R, Sandomenico F et al (2004). Real time contrastenhanced imaging in emergency radiology. Radiol Med (Torino) 108(5–6):454–469

    Google Scholar 

  12. Miele V, Buffa V, Stasolla A et al (2004) Contrast enhanced ultrasound with second generation contrast agent in traumatic liver lesions. Radiol Med (Torino) 108(1–2):82–91

    Google Scholar 

  13. Oldenburg A, Hohmann J, Skrok J, Albrecht T (2004) Imaging of paediatric splenic injury with contrastenhanced ultrasonography. Pediatr Radiol 34(4):351–354

    Article  PubMed  Google Scholar 

  14. Yegiyants S, Abou-Lahoud G, Taylor E (2006) The management of blunt abdominal trauma patients with computed tomography scan findings of free peritoneal fluid and no evidence of solid organ injury. Am Surg 72(10):943–946

    PubMed  Google Scholar 

  15. Brenchley J, Walker A, Sloan JP et al (2006) Evaluation of focussed assessment with sonography in trauma (FAST) by UK emergency physicians. Emerg Med J 23(6):446–448

    Article  PubMed  CAS  Google Scholar 

Download references

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Authors and Affiliations

  1. Imaging Diagnosis Center, Herlev Hospital, DK-2730, Herlev, Denmark

    Lars Thorelius

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  1. Lars Thorelius
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Correspondence to Lars Thorelius.

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Thorelius, L. Emergency real-time contrast-enhanced ultrasonography for detection of solid organ injuries. Eur Radiol Suppl 17 (Suppl 6), 107–111 (2007). https://doi.org/10.1007/s10406-007-0235-4

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  • DOI: https://doi.org/10.1007/s10406-007-0235-4

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