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Screening US and CT for blunt abdominal trauma: A retrospective study.
No full textScreening US and CT for blunt abdominal trauma: A retrospective study
* Giuseppetti Gian MarcoCorresponding author contact information, E-mail the corresponding author,
* Salera Diego,
* Argalia Giulio,
* Salvolini Luca
* Institute of Radiology, Polytechnic University of Marche Medical School, Umberto I Hospital, Ancona, Italy
* Received 20 October 2004. Revised 31 January 2005. Accepted 1 February 2005. Available online 5 March 2005.
* http://dx.doi.org/10.1016/j.ejrad.2005.02.001, How to Cite or Link Using DOI
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Cited by in Scopus (14)
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Abstract
Objective:
To assess the accuracy of screening US and CT in patients with blunt abdominal trauma admitted to the trauma centre of our General Hospital.
Materials and method:
The abdominal US reports of 864 primary trauma patients (139 with major and 725 with minor injuries) and 162 CT reports of a subgroup of the same subjects (64 with major and 98 with minor injuries) were reviewed and compared to the best available reference standard. The accuracy of screening US was assessed by evaluating its overall ability to distinguish negative from positive cases by showing at least one of the lesions documented by the reference standard and its specific ability to depict all lesions; CT reports were evaluated only for the method's performance in depicting all lesions.
Results:
Screening US exhibited a satisfactory overall ability to distinguish negative from positive patients (91.5% sensitivity and 97.5% specificity in major trauma patients versus 73.3% sensitivity and 98.1% specificity in the minor trauma group) and a satisfactory specific ability to depict all injuries in major trauma patients. In minor trauma cases sensitivity was satisfactory for free fluid but unsatisfactory for organ injuries. Of the 21/864 false negative reports (5 in patients with major and 16 in cases with minor traumas), only one affected patient management, a major trauma case, by delaying an emergency laparotomy. The performance of CT in detecting each single lesion was predictably excellent in both patient groups.
Conclusion:
Its satisfactory accuracy for major trauma suggests that US could be employed not only to screen cases for emergency laparotomy but also as an alternative to CT. However, since major traumatic injuries generally carry an imperative indication for CT, especially as regards neurological, thoracic and skeletal evaluation, US should be employed to perform a prompt preliminary examination using a simplified technique in the emergency room simultaneously with resuscitation.
Keywords
* Emergency screening US;
* Blunt abdominal trauma;
* Emergency radiolog
Contrast-enhanced ultrasound in delayed splenic vascular injury and active extravasation diagnosis
No full textINTRODUCTION:
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
Suspected pulmonary embolism and deep venous thrombosis: A comprehensive MDCT diagnosis in the acute clinical setting
No full textAssociation of carcinoma of the breast and endocranial meningioma. Description of a case and review of the literature
No full text
Usefulness of ultrasonography and color Doppler sonography in the diagnosis of major salivary gland diseases
No full textUtility of an open-source DICOM viewer software (OsiriX) to assess pulmonary fibrosis in systemic sclerosis: preliminary results.
No full textThe study provides the new working hypothesis that OsiriX may be a useful and feasible tool to achieve a quantitative evaluation of PF in SSc patients
Atherosclerosis in rheumatoid arthritis: the role of high-resolution B mode ultrasound in the measurement of the arterial intima-media thicknes
No full textOur results confirm an accelerated atherosclerosis, as shown by increased common carotid IMT, in patients with RA compared with controls and it is related mainly to lipid levels. High-resolution B-mode ultrasound may be considered a promising, sensitive and non invasive tool for assessing the existence of subclinical atherosclerosis in RA patient
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