Contrast enhanced ultrasonography for blunt abdominal trauma imaging in children
Aaron Chen, MD
BACKGROUND: Trauma is one of the leading causes of morbidity and mortality in children, and in children with blunt abdominal trauma, computed tomography (CT) is considered the gold standard for evaluation of solid organ injuries. Contrast-enhanced ultrasound is a newer modality which has potential advantages over CT in terms of cost, lack of ionizing radiation exposure, and its ability to be performed at the bedside. GAP: Preliminary data, mostly from European countries and in adults, suggests that contrast-enhanced ultrasound has good test characteristics for the detection of solid organ injuries in patients with blunt abdominal trauma, however it has not been extensively studied in children and is very infrequently used in clinical practice today. HYPOTHESIS: Contrast enhanced ultrasound has good sensitivity and specificity as compared to a gold standard conventional CT scan for the identification of intra-abdominal solid organ injury in hemodynamically stable children with blunt abdominal trauma. METHODS: This will be a prospective observational study of children 0-18 years with hemodynamically stable blunt abdominal trauma and for whom a CT scan of the abdomen and pelvis is planned or has been performed. Subjects will receive a contrast-enhanced ultrasound for comparison to the gold standard CT scan, and charts will be abstracted for clinical and demographic data. RESULTS: pending IMPACT: If this study is able to confirm preliminary findings from European literature that contrast enhanced ultrasound is a safe and effective imaging modality for the initial evaluation of children with blunt abdominal trauma, it could ultimately lead to more widespread acceptance and use of ultrasound, with a corresponding reduction in the use of CT. This has the potential to significantly reduce overall healthcare costs, improve efficiencies in care, and reduce the risk of malignancies associated with radiation exposure.
Computerized Tomography, Diagnosis, Emergency Department, Imaging