Effectiveness of contrast-enhanced ultrasound and serum liver enzyme measurement in detection and classification of blunt liver trauma

Abstract

ObjectiveThis study was performed to identify the correlation between contrast-enhanced ultrasound (CEUS) and contrast-enhanced multidetector computed tomography (CE-MDCT) as well as the correlation between serum liver enzyme concentrations and CE-MDCT in classification of the severity of blunt hepatic trauma using CE-MDCT as a reference standard.Materials and methodsA blunt liver trauma model was created using 20 rabbits, and CE-MDCT, CEUS, and serum liver enzyme assays were performed. A radiologist and an ultrasound physician independently evaluated the degree of liver trauma. The diagnostic performance of CEUS and serum liver enzyme measurements was compared with that of CE-MDCT using Spearman’s correlation analysis and Pearson’s correlation analysis, respectively.ResultsSpearman’s rank correlation coefficient between the CEUS-based classification and CE-MDCT was 0.888. The aspartate aminotransferase and lactate dehydrogenase concentrations and the aspartate aminotransferase/alanine aminotransferase ratio were positively correlated with the grade of liver injury; Pearson’s correlation coefficients were 0.664, 0.704, and 0.503, respectively. The gamma-glutamyltransferase concentration had a significantly negative correlation with the grade of liver injury (r = −0.467).ConclusionsCEUS and serum liver enzyme measurement exhibited high consistency with CE-MDCT for both detection and grading of intraparenchymal lesions in blunt liver trauma. These techniques may permit more accurate diagnosis of liver trauma.

Sodium Alginate as Treatment for Penetrating Abdominal Trauma- Feasibility Study.

“…In order to establish a valid trauma model, one must demonstrate change in several parameters that re ect the degree of organ damage and shock. Those parameters include hemodynamics, blood biochemical pro le, endocrine pro le and in our model also markers of hepatic tissue damage (23)(24)(25)(26). Also histopathologic samples from liver tissues in a setting of shock demonstrate certain changes such as central lobular necrosis (27).…”

The acute care diagnostics collaboration: performance assessment of contrast-enhanced ultrasound compared to abdominal computed tomography and conventional ultrasound in an emergency trauma score bayesian clinical decision scheme

“…Previously published literature also provides evidence of the superiority of CT and CEUS over simple abdominal US. [ 8 9 10 11 12 13 14 ] More specifically, Catalano et al . [ 14 ] evaluated concordance of results among US and CEUS in patients with blunt abdominal trauma, showing an increase in sensitivity, specificity, and accuracy when using CEUS.…”

“…Sensitivity and specificity for US, CT, and CEUS were obtained from pooled data and used to calculate LR− and LR+ [ Figure 1 ]. [ 10 11 12 13 ]…”

<p>Combination of liver enzymes, amylase and abdominal ultrasound tests have acceptable diagnostic values as an alternative test for abdominopelvic CT scan in blunt abdominal trauma</p>

“…Physicians often use a combination of radiology and ultrasonography (US) to perform a primary assessment of patients suffering from high-energy traumas or trauma patients with low levels of consciousness. In this regard, FAST (focused assessment with US for trauma) is a useful modality for the primary assessment of trauma patients, which does not make any difference in the resuscitation maneuvers 6. FAST mainly serves the rapid diagnosis of the fluid in the peritoneum in patients suffering from blunt abdominal trauma and low blood pressure.…”

“…FAST mainly serves the rapid diagnosis of the fluid in the peritoneum in patients suffering from blunt abdominal trauma and low blood pressure. Its other advantages include its high accuracy and speed, noninvasiveness, repeatability and being replaceable 6. Although the sensitivity of FAST in the diagnosis of the fluid in the peritoneum is higher than a CT scan, a CT scan helps decide on the treatment (surgical or nonsurgical) with a positive FAST result 7.…”