Contrast-enhanced ultrasound proves nearly as accurate as CT for assessing abdominal trauma in children

Contrast-enhanced ultrasound is almost as accurate as contrast-enhanced CT for diagnosing solid organ injuries in children following blunt abdominal trauma. This less expensive option is also beneficial because it doesn't require irradiating young patients.

Dr. Massimo Valentino and colleagues from various specialist departments at the University Hospital in Bologna, Italy, published their study in Radiology, which made it available online Jan. 14. They studied 27 consecutive pediatric patients: 19 boys and eight girls with a mean age of 8.9 years. All patients had suffered blunt abdominal trauma and were assessed for solid organ injuries.

The researchers conducted both standard ultrasound and contrast-enhanced ultrasound exams on each patient as well as a contrast-enhanced CT scan. The results were then compared and evaluated for sensitivity, specificity, agreement, accuracy, number of lesions correctly identified, positive predictive value, and negative predictive value.

Contrast-enhanced CT scans identified no solid organ injuries in 15 patients. The CT scans found a total of 14 injuries in the other 12 patients: seven injured spleens, four injured livers, one right kidney, one right adrenal gland, and one pancreas.

Standard ultrasound exams showed free fluid in two of the 15 patients with negative CT scans. Of the 12 patients with CT-identified injuries, standard ultrasound showed free fluid, parenchymal lesions, or both in eight.

Contrast-enhanced ultrasound exams showed no lesions in the 15 patients with negative CT scans but found 13 of the 14 lesions identified in contrast-enhanced CT scans. Contrast-enhanced ultrasound has a sensitivity of 92.2%, specificity of 100%, positive predictive value of 100%, and negative predictive value of 93.8%.

The researchers made some of their contrast-enhanced ultrasound exams available online and concluded that contrast-enhanced ultrasound is almost as accurate as contrast-enhanced CT when looking for solid organ injuries in children with blunt abdominal trauma.