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Contrast-enhanced ultrasound in delayed splenic vascular injury and active extravasation diagnosis

  • ABDOMINAL RADIOLOGY
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Abstract

Introduction

We describe the use of contrast-enhanced ultrasound (CEUS) in the diagnosis of delayed splenic vascular injury (DSVI) and active extravasation (DAE) during spleen injury follow-up. CEUS might be used instead of contrast-enhanced computed tomography (CECT) during spleen injury follow-up in order to reduce radiation exposure.

Objective

Assess diagnostic comparability between CEUS and CECT in the evaluation of DSVI and DAE during spleen injury follow-up.

Subjects and methods

A total of 139 trauma patients (101 males, 38 females; mean age 48.6 years) with CECT diagnosed spleen injury were prospectively evaluated. They performed CEUS and CECT follow-up. All CEUS studies were performed using the same ultrasound scan, convex probe, mechanical index and ultrasound contrast agent dose. Twelve patients performed digital subtraction angiography (DSA) during follow-up, and the diagnostic performance comparability between CEUS and DSA was evaluated.

Results

CEUS showed 17 delayed spleen injury complications, and in 122 patients no complication was suspected. CECT diagnosed 16 delayed spleen injury complications in these 17 patients and showed a small DSVI in another patient. A total of 122 follow-up CT scans were negative. CEUS and CECT diagnostic comparability was 98.6%. Compared to DSA, CEUS showed a sensitivity of 100% and a positive predictive value of 91.7%.

Conclusions

CEUS can be used during spleen injury follow-up instead of CECT. Positive CEUS examinations could perform CECT and, when necessary, DSA in order to confirm and treat spleen injury complications.

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Authors and Affiliations

  1. School of Radiology, Università Politecnica delle Marche, Ancona, Italy

    Corrado Tagliati

  2. SOD Clinica di Radiologia, d’Urgenza e dell’Area Oncologica, Azienda Ospedaliero Universitaria Ospedali Riuniti, Ancona, Italy

    Giulio Argalia

  3. Department of Radiological Sciences, Azienda Ospedaliero Universitaria Ospedali Riuniti, Università Politecnica delle Marche, Ancona, Italy

    Gabriele Polonara, Andrea Giovagnoni & Gian Marco Giuseppetti

Authors
  1. Corrado Tagliati
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  2. Giulio Argalia
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  3. Gabriele Polonara
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  4. Andrea Giovagnoni
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  5. Gian Marco Giuseppetti
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Correspondence to Corrado Tagliati.

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The authors declared no potential conflicts of interests associated with this study.

Ethical standard

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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Tagliati, C., Argalia, G., Polonara, G. et al. Contrast-enhanced ultrasound in delayed splenic vascular injury and active extravasation diagnosis. Radiol med 124, 170–175 (2019). https://doi.org/10.1007/s11547-018-0961-9

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  • DOI: https://doi.org/10.1007/s11547-018-0961-9

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