Blunt abdominal trauma: role of contrast-enhanced ultrasound (CEUS) in the detection and staging of abdominal traumatic lesions compared to US and CE-MDCT

Sessa, Barbara; Trinci, Margherita; Ianniello, Stefania; Menichini, G; Galluzzo, Michele; Miele, Vittorio

doi:10.1007/s11547-014-0425-9

Cited by 105 publications

(67 citation statements)

References 20 publications

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“…On the other hand, CEUS only marginally increased diagnostic accuracy for the detection of haemoperitoneum, where ultrasonography alone was sufficiently accurate. 42 Similar conclusions regarding the accuracy of CEUS for the detection of solid organ traumas were drawn by other mixed populations studies. 35,[43][44][45] As a consequence, it is reasonable to assume that CEUS could replace ultrasonography for the initial screening of low-or moderate-energy, isolated abdominal trauma and CT should be used only for the exclusion of active haemorrhage in a patient who is haemodynamically unstable with negative ultrasonography for active bleeding.…”

Section: Clinical Applications Blunt Abdominal Traumasupporting

confidence: 75%

Enhancing the role of paediatric ultrasound with microbubbles: a review of intravenous applications

Rafailidis¹,

Deganello²,

Watson³

et al. 2017

BJR

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Contrast-enhanced ultrasound (CEUS) represents a complementary technique to greyscale and colour Doppler ultrasonography which allows for real-time visualization and characterization of tissue perfusion. Its inherent advantages in the child makes ultrasonography an ideal imaging modality; repeatability and good tolerance along with the avoidance of CT, a source of ionizing radiation, renders ultrasonography imaging desirable. Although currently paediatric CEUS is principally used in an "off-label" manner, ultrasonography contrast agents have received regulatory approval for assessment of paediatric focal liver lesions (FLL) in the USA. The safety of ultrasound contrast-agents is well documented in adults, as safe as or even surpassing the safety profile of CT and MR contrast agents. Except for the established intracavitary use of CEUS in voiding urosonography, i.v. paediatric applications have been introduced with promising results in the abdominal trauma initial diagnosis and follow-up, characterization and differential diagnosis of FLL and characterization of lung, pleura, renal and splenic pathology. CEUS has also been used to detect complications after paediatric transplantation, evaluate inflammatory bowel disease activity and assess tumour response to antiangiogenic therapy. The purpose of this review was to present these novel i.v. paediatric applications of CEUS and discuss their value.

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Section: Clinical Applications Blunt Abdominal Traumasupporting

confidence: 75%

Enhancing the role of paediatric ultrasound with microbubbles: a review of intravenous applications

Rafailidis¹,

Deganello²,

Watson³

et al. 2017

BJR

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show abstract

“…The study was able to show that CEUS technology has a high value for radiology users for the diagnosis of organ lesions -primarily the liver -and also for diagnosing endoleaks in the follow-up of vascular prostheses. However, in light of the fact that CEUS is highly useful for the diagnosis of trauma cases [7], it is interesting that the method has been used to date only relatively rarely for this purpose outside the trauma room and extremely rarely in the trauma room.…”

Section: Discussionmentioning

confidence: 99%

“…The low representation of CEUS in diagnosis in trauma cases outside and especially in the trauma room in pediatric radiology is particularly striking. Amazingly, the percentage of use of this radiation-free modality with no systemic contrast toxicity and the ability to visualize organ lacerations with high sensitivity in the latter indications is only insignificantly higher than in radiology in adults [7].…”

Section: Discussionmentioning

confidence: 99%

“…CEUS is important not only for the evaluation of liver lesions [1 -3] but also for the diagnosis of pathologies of other parenchymatous organs, for vascular diagnosis [4,5] and for intracavitary purposes [6]. Due to its high diagnostic significance, CEUS should be increasingly used also for diagnosis in trauma cases in the future [7]. Analysis of the current situation indicates that this modality is only rarely used by radiologists and is primarily employed by other medical disciplines.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of the Value of Contrast-Enhanced Ultrasound (CEUS) within Radiology Departments in Germany

Graeter

Kratzer

Seufferlein

et al. 2017

Fortschr Röntgenstr

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ABSTR AC TPurpose Contrast-enhanced ultrasound (CEUS) has been established for many years and has become an increasingly important cornerstone of the diagnostic imaging of various organ systems. However, this modality is rarely performed by radiologists and is primarily employed by other medical disciplines. The goal of this questionnaire study is to present the current value of CEUS in radiology and to encourage reevaluation of the method within this medical discipline.Materials and Methods 560 directors of radiology departments throughout Germany were contacted and given a 3-page questionnaire. The questionnaire included 37 questions on 5 different topics (general structures, CEUS and interdisciplinarity, CEUS in pediatric radiology, education/professional development, outlook) to assess the value of ultrasound (US) and in particular CEUS in radiology.Results The response rate was 42.3 %. A statistical analysis of the answers was performed, including subgroup analysis. Overall, it could be shown that CEUS is performed in comparatively few radiology departments (26.6 %), while the current value of the modality is given an average to high range of importance even by radiologists. More than half of all participating radiologists (54.9 %) would like this method to be included in the requirements catalog for the specialist examination. ConclusionThe nationwide questionnaire to evaluate CEUS within radiology departments in Germany had a very high response rate, which reflects the assessment of this topic by radiologists. There is a substantial discrepancy between the currently low utilization of CEUS in radiology and the high ranking of CEUS by many radiologists. The analyses of the replies point out important aspects of professional policy regarding this topic within the radiology community. Key points▪ The high response rate reflects the assessment of this topic by radiologists. ▪ The questionnaire study depicts the currently low use of CEUS in radiology. ▪ CEUS is given a high range of importance by radiologists.

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“…Recently, some studies proved the role of contrast-enhanced US in the lesion detection and grading in patients with minor abdominal trauma. 32,33 Direct US signs of small bowel perforation are strong reverberation anteriorly to the liver surface, shifting phenomenon and "scissors maneuver" (when the patient changes position the air moves to the highest portion of abdominal cavity). 34 The scissors maneuver is the following: applying a A B Figure 5 Abdominal CT shows the presence of free abdominal air (A and B, arrow) in the abdominal cavity due to large bowel perforation.…”

Section: Us Techniquementioning

confidence: 99%

Small Bowel Perforations: What the Radiologist Needs to Know

Mantia

Picone

et al. 2016

Seminars in Ultrasound, CT and MRI

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The incidence of small bowel perforation is low but can develop from a variety of causes including Crohn disease, ischemic or bacterial enteritis, diverticulitis, bowel obstruction, volvulus, intussusception, trauma, and ingested foreign bodies. In contrast to gastroduodenal perforation, the amount of extraluminal air in small bowel perforation is small or absent in most cases. This article will illustrate the main aspects of small bowel perforation, focusing on anatomical reasons of radiological findings and in the evaluation of the site of perforation using plain film, ultrasound, and multidetector computed tomography equipments. In particular, the authors highlight the anatomic key notes and the different direct and indirect imaging signs of small bowel perforation.

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Blunt abdominal trauma: role of contrast-enhanced ultrasound (CEUS) in the detection and staging of abdominal traumatic lesions compared to US and CE-MDCT

Abstract: In patients with low-energy isolated abdominal trauma US should be replaced by CEUS as the first-line approach, as it shows a high sensitivity both in lesion detection and grading. CE-MDCT must always be performed in CEUS-positive patients to exclude active bleeding and urinomas.

Cited by 105 publications

References 20 publications

Enhancing the role of paediatric ultrasound with microbubbles: a review of intravenous applications

Enhancing the role of paediatric ultrasound with microbubbles: a review of intravenous applications

Evaluation of the Value of Contrast-Enhanced Ultrasound (CEUS) within Radiology Departments in Germany

Small Bowel Perforations: What the Radiologist Needs to Know

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