Demosthenes D. Cokkinos MD, Presenter: Nothing to Disclose

Eleni Antypa, Abstract Co-Author: Nothing to Disclose

Konstantinos Stefanidis MD, Abstract Co-Author: Nothing to Disclose

Vassilios Panagiotis Kostaras MD, Abstract Co-Author: Nothing to Disclose

Stylianos V. Benakis MD, Abstract Co-Author: Nothing to Disclose

Ploutarchos N. Piperopoulos MD, PhD, Abstract Co-Author: Nothing to Disclose

To evaluate the ability of contrast enhanced ultrasound (CEUS) to be performed on an emergency basis, thus solving clinical problems in a short amount of time.

We reviewed imaging results of 53 patients who presented in the Emergency Department and were scanned with CEUS. 35 patients were examined for blunt abdominal trauma, 6 for testicular emergencies (trauma 4-torsion 2), 5 for abdominal vessels emergencies (aortic and inferior vena cava  thrombosis or suspected aortic aneurysm leak), 3 for extremity vessels emergencies (arterial obstruction or venous thrombosis) and 4 for internal carotid artery  obstruction. The time needed to perform the scan was noted. CEUS results were analysed in order to assess the technique’s ability to give a diagnosis under emergency conditions.

The time needed to perform a CEUS examination (excluding baseline non enhanced scan) ranged between 9 and 21 minutes (median 14.3 minutes). CEUS imaged abdominal trauma in 25/35 patients, changing the diagnosis of baseline US in 12 patients. Trauma was confirmed with CT in 17 cases. In all 6 scrotal history patients CEUS confirmed the pathology suggested on baseline US. Inferior vena cava thrombosis was noted in 1 patient. No aortic thrombosis or leak was found. Radial artery obstruction was seen in 1 patient with intravenous drugs history. 2 internal carotid artery thrombosis cases suggested on baseline US were confirmed on CEUS and 1 dissection was imaged on CEUS and confirmed on angiography. Altogether CEUS elucidated or increased confidence for B mode, Colour and spectral Doppler findings in 33 patients and set a diagnosis not evident before contrast injection in 19 cases.

In all cases CEUS was helpful in answering an emergency clinical question in a reasonable time period. It can be suggested as a technique which aids baseline US, increasing its usefulness and decreasing undiagnostic scans.

If CEUS increases the diagnostic performance of baseline US in a short time period, it can help to avoid US scanning repetitions or decrease further imaging with CT, MR and angiography.

Cokkinos, D, Antypa, E, Stefanidis, K, Kostaras, V, Benakis, S, Piperopoulos, P, Emergency Contrast-enhanced Ultrasound: Can It Be Done?.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11003577.html