Paul Singh Sidhu MD, Presenter: Nothing to Disclose

Orlando Catalano MD, Abstract Co-Author: Nothing to Disclose

Armanda De Marchi, Abstract Co-Author: Nothing to Disclose

Massimo Valentino MD, Abstract Co-Author: Nothing to Disclose

Angelo Ziosi, Abstract Co-Author: Nothing to Disclose

Alberto Martegani MD, Abstract Co-Author: Nothing to Disclose

To evaluate the concordance of US and contrast enhanced US (CEUS) with contrast enhanced CT (CECT) as a reference standard in the assessment of solid organ injury following blunt abdominal trauma

Patients presenting acutely with a history of blunt abdominal trauma at 6 centres were recruited. They underwent a complete abdominal US examination, followed by a CEUS using low Mechanical Index techniques (Esaote with CnTi® or ATL 5000 with Pulse Inversion®), employing SonoVue® (Bracco Imaging SpA)(2x2.4 mL bolus injections) as the microbubble agent. Assessment of the kidneys (early arterial phase), liver and spleen (later portal venous phase) was performed according to a predetermined schedule and the nature of the injuries recorded by the investigator at both baseline US and CEUS. Pts underwent a CECT examination within 1 hour of the CEUS examination, and all injuries noted. Comparisons were made off-site between the US, CEUS and the CECT findings to document the concordance of the 3 imaging modalities.

Among the 156 patients, 65 had no abdominal abnormality and 91 had one or more abnormalities (n=106) at CECT with the following distribution: 26 renal, 38 liver, 43 spleen. At baseline US the distribution of abnormalities was: 12 renal, 29 liver, 37 spleen. Following CEUS the distribution was: 19 renal, 33 liver, 41 spleen. Sensitivity, specificity and accuracy for renal at baseline US were 25.4%, 97.9% and 89.4% resp.; after CEUS values increased to 69.3%, 99.6% and 97.1%. For liver baseline US values were 44.7%, 94.7% and 84.6%; after CEUS were 78.3%, 98.3% and 93.6%. For spleen, results were 66.7%, 83.2% and 80.1% at baseline US and 90.5%, 96.6% and 96.8% after CEUS. Per patient evaluation gave the following results in terms of sensitivity, specificity and accuracy: 37.2%, 82.9%, 57.7% at baseline US; 83.7% 96.9% and 89.1% following CEUS. A definite or possible diagnosis was reached in 83, 138 and 149/156 patients undergoing basal, CEUS or CECT, resp.

CEUS was found to be more sensitive than US and almost as sensitive as CECT in the detection of solid organ injury in blunt abdominal trauma, potentially reducing the need for further imaging.

Sidhu, P, Catalano, O, De Marchi, A, Valentino, M, Ziosi, A, Martegani, A, Microbubble Contrast Ultrasound Imaging of Solid Organ Injury in Blunt Abdominal Trauma: Results of an International Multi-centre Prospective Study.  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4411841.html