Blunt Abdominal Trauma: Does the Use of a Second-Generation Sonographic Contrast Agent Help to Detect Solid Organ Injuries?
| Autor: | Bernard Vermeulen, Alexandra Platon, François Terrier, Gilles Mentha, Leo Buhler, Christoph D. Becker, Pierre-Alexandre Alois Poletti |
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| Rok vydání: | 2004 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Sulfur Hexafluoride Contrast Media Abdominal Injuries Wounds Nonpenetrating ddc:616.0757 Sensitivity and Specificity Lesion Hemodynamically stable Pseudoaneurysm Blunt medicine Humans Sulfur Hexafluoride/diagnostic use Focused assessment with sonography for trauma Radiology Nuclear Medicine and imaging In patient Abdominal Injuries/radiography/ultrasonography Phospholipids Ultrasonography Aged Aged 80 and over ddc:617 business.industry Wounds Nonpenetrating/radiography/ultrasonography General Medicine Middle Aged medicine.disease Surgery Viscera Abdominal trauma Female Viscera/injuries/radiography/ultrasonography Solid organ Radiology medicine.symptom Tomography X-Ray Computed business Phospholipids/diagnostic use |
| Zdroj: | American Journal of Roentgenology, Vol. 183, No 5 (2004) pp. 1293-301 |
| ISSN: | 1546-3141 0361-803X |
| DOI: | 10.2214/ajr.183.5.1831293 |
| Popis: | The objective of our study was to prospectively evaluate whether a second-generation sonography contrast agent (SonoVue) can improve the conspicuity of solid organ injuries (liver; spleen; or kidney, including adrenal glands) in patients with blunt abdominal trauma.Two hundred ten consecutive hemodynamically stable trauma patients underwent both abdominal sonography and CT at admission. The presence of solid organ injuries and the quality of sonography examinations were recorded. Patients with false-negative sonography findings for solid organ injuries in comparison with CT results underwent control sonography. If a solid organ injury was still undetectable, contrast-enhanced sonography was performed. Findings of admission, control, and contrast-enhanced sonograms were compared with CT results for their ability to depict solid organ injuries. Contrast-enhanced sonography was also performed in patients in whom a vascular injury (pseudoaneurysm) was shown on admission or control CT.CT findings were positive for 88 solid organ injuries in 71 (34%) of the 210 patients. Admission, control, and contrast-enhanced sonograms had a detection rate for solid organ injury of 40% (35/88), 57% (50/88), and 80% (70/88), respectively. The improvement in the detection rate between control and contrast-enhanced sonography was statistically significant (p = 0.001). After exclusion of low-quality examinations, contrast-enhanced sonography still missed 18% of solid organ injuries. Five vascular liver (n = 1) and spleen (n = 4) injuries (pseudoaneurysms) were detected on CT; all were visible on contrast-enhanced sonography.Contrast-enhanced sonography misses a large percentage of solid organ injuries and cannot be recommended to replace CT in the triage of hemodynamically stable trauma patients. However, contrast-enhanced sonography could play a role in the detection of pseudoaneurysms. |
| Databáze: | OpenAIRE |
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