Radiology, Oslo University Hospital.
Ultraschall Med. 2011 Oct;32(5):485-91. doi: 10.1055/s-0029-1246003. Epub 2011 Feb 3.
The aim of this study was to compare the diagnostic performance of contrast-enhanced ultrasound (CEUS) to computed tomography (CT) in trauma patients after splenic embolization.
22 patients (17 male and 5 female) with a mean age of 32 (15 - 57 years) were studied with ultrasound (US), CEUS and CT in 23 early follow-up examinations 5 days (range: 0 - 12 days) after intervention and 17 late follow-up examinations 69 days (range: 52 - 189 days) after intervention. Perisplenic fluid, hematoma, laceration, infarction, scars and injury grade were evaluated. US and CEUS readings were performed independently by two radiologist, blinded to the CT results.
The sensitivity and specificity for CEUS at early follow-up were 85 % and 70 % for perisplenic fluid, 80 % and 94 % for subcapsular hematomas, 83 % and 73 % or lacerations and 75 % and 87 % for infarctions, respectively. The sensitivity and specificity at late follow-up were 60 % and 100 % for subcapsular hematomas, 91 % and 67 % for intrasplenic hematomas, 100 % and 93 % for lacerations and 89 % and 100 % for scars, respectively. The overall sensitivity and specificity for all lesions were 87 % and 88 % at early follow-up (n = 138) and 85 % and 95 % at late follow-up (n = 102), respectively. Compared to CT, CEUS underestimated the injury grade in 2 / 40 cases and overestimated the injury grade in 3/40 cases.
CEUS is a useful tool for the detection of post-traumatic lesions. It is comparable to CT in follow-up after splenic embolization and may replace CT in follow-up studies.
本研究旨在比较对比增强超声（CEUS）与计算机断层扫描（CT）在脾栓塞后创伤患者中的诊断性能。
本研究共纳入 22 名患者（男 17 例，女 5 例；年龄 15-57 岁，平均 32 岁）。在介入后 5 天（范围：0-12 天）和介入后 69 天（范围：52-189 天）进行了 23 次早期随访检查和 17 次晚期随访检查，分别进行了超声、CEUS 和 CT 检查。评估了脾周积液、血肿、撕裂伤、梗死、瘢痕和损伤分级。US 和 CEUS 阅读由两位放射科医生独立进行，对 CT 结果不知情。
早期随访时，CEUS 对脾周积液的灵敏度和特异度分别为 85%和 70%，对包膜下血肿的灵敏度和特异度分别为 80%和 94%，对撕裂伤的灵敏度和特异度分别为 83%和 73%，对梗死的灵敏度和特异度分别为 75%和 87%。晚期随访时，CEUS 对包膜下血肿的灵敏度和特异度分别为 60%和 100%，对脾内血肿的灵敏度和特异度分别为 91%和 67%，对撕裂伤的灵敏度和特异度分别为 100%和 93%，对瘢痕的灵敏度和特异度分别为 89%和 100%。早期随访时（n=138），所有病变的总灵敏度和特异度分别为 87%和 88%，晚期随访时（n=102）分别为 85%和 95%。与 CT 相比，CEUS 低估了 40 例中的 2 例损伤分级，高估了 40 例中的 3 例。
CEUS 是一种用于检测创伤后病变的有用工具。它在脾栓塞后的随访中与 CT 相当，并且可能在随访研究中替代 CT。
