U.O. Radiologia, Policlinico S. Orsola-Malpighi, Bologna, Italy.
Radiol Med. 2009 Oct;114(7):1080-93. doi: 10.1007/s11547-009-0444-0. Epub 2009 Sep 22.
The aim of the study was to evaluate the diagnostic capability of contrast-enhanced ultrasonography (CEUS) in a large series of patients with blunt abdominal trauma.
We studied 133 haemodynamically stable patients with blunt abdominal trauma. Patients were assessed by ultrasonography (US), CEUS and multislice computed tomography (MSCT) with and without administration of a contrast agent. The study was approved by our hospital ethics committee (clinical study no. 1/2004/O).
In the 133 selected patients, CT identified 84 lesions; namely, 48 splenic, 21 hepatic, 13 renal or adrenal and two pancreatic. US identified free fluid or parenchymal alterations in 59/84 patients with positive CT and free fluid in 20/49 patients with negative CT. CEUS detected 81/84 traumatic lesions identified on CT and ruled out traumatic lesions in 48/49 patients with negative CT. The sensitivity, specificity and positive and negative predictive values of US were 70.2%, 59.2%, 74.7% and 53.7%, respectively, whereas those of CEUS were 96.4%, 98%, 98.8% and 94.1%, respectively.
Our study showed that CEUS is an accurate technique for evaluating traumatic lesions of solid abdominal organs. The technique is able to detect active bleeding and vascular lesions, avoids exposure to ionising radiation and is useful for monitoring patients undergoing conservative treatment.
本研究旨在评估对比增强超声（CEUS）在大量钝性腹部创伤患者中的诊断能力。
我们研究了 133 例血流动力学稳定的钝性腹部创伤患者。患者接受了超声（US）、CEUS 和多层计算机断层扫描（MSCT）检查，其中包括和不包括造影剂的应用。该研究得到了我院伦理委员会的批准（临床研究编号 1/2004/O）。
在 133 名入选患者中，CT 发现了 84 处病变；即 48 处脾脏、21 处肝脏、13 处肾脏或肾上腺和 2 处胰腺。US 在 59/84 例 CT 阳性患者中发现了游离液体或实质改变，在 20/49 例 CT 阴性患者中发现了游离液体。CEUS 检测到 81/84 例 CT 发现的创伤性病变，并在 48/49 例 CT 阴性患者中排除了创伤性病变。US 的敏感性、特异性、阳性预测值和阴性预测值分别为 70.2%、59.2%、74.7%和 53.7%，而 CEUS 的敏感性、特异性、阳性预测值和阴性预测值分别为 96.4%、98%、98.8%和 94.1%。
本研究表明，CEUS 是评估腹部实质器官创伤性病变的一种准确技术。该技术能够检测到活动性出血和血管病变，避免了电离辐射的暴露，并且对于监测接受保守治疗的患者是有用的。
