School of Radiology, Università Politecnica delle Marche, Ancona, Italy.
SOD Clinica di Radiologia, d'Urgenza e dell'Area Oncologica, Azienda Ospedaliero Universitaria Ospedali Riuniti, Ancona, Italy.
Radiol Med. 2019 Mar;124(3):170-175. doi: 10.1007/s11547-018-0961-9. Epub 2018 Nov 28.
We describe the use of contrast-enhanced ultrasound (CEUS) in the diagnosis of delayed splenic vascular injury (DSVI) and active extravasation (DAE) during spleen injury follow-up. CEUS might be used instead of contrast-enhanced computed tomography (CECT) during spleen injury follow-up in order to reduce radiation exposure.
Assess diagnostic comparability between CEUS and CECT in the evaluation of DSVI and DAE during spleen injury follow-up.
A total of 139 trauma patients (101 males, 38 females; mean age 48.6 years) with CECT diagnosed spleen injury were prospectively evaluated. They performed CEUS and CECT follow-up. All CEUS studies were performed using the same ultrasound scan, convex probe, mechanical index and ultrasound contrast agent dose. Twelve patients performed digital subtraction angiography (DSA) during follow-up, and the diagnostic performance comparability between CEUS and DSA was evaluated.
CEUS showed 17 delayed spleen injury complications, and in 122 patients no complication was suspected. CECT diagnosed 16 delayed spleen injury complications in these 17 patients and showed a small DSVI in another patient. A total of 122 follow-up CT scans were negative. CEUS and CECT diagnostic comparability was 98.6%. Compared to DSA, CEUS showed a sensitivity of 100% and a positive predictive value of 91.7%.
CEUS can be used during spleen injury follow-up instead of CECT. Positive CEUS examinations could perform CECT and, when necessary, DSA in order to confirm and treat spleen injury complications.
我们描述了对比增强超声（CEUS）在诊断脾损伤随访中延迟性脾血管损伤（DSVI）和活动性外渗（DAE）中的应用。CEUS 可替代脾损伤随访中的对比增强计算机断层扫描（CECT），以减少辐射暴露。
评估 CEUS 和 CECT 在脾损伤随访中评估 DSVI 和 DAE 中的诊断可比性。
共前瞻性评估了 139 例 CECT 诊断为脾损伤的创伤患者（男性 101 例，女性 38 例；平均年龄 48.6 岁）。他们进行了 CEUS 和 CECT 随访。所有 CEUS 研究均使用相同的超声扫描、凸阵探头、机械指数和超声造影剂剂量进行。12 例患者在随访期间进行了数字减影血管造影（DSA），评估了 CEUS 和 DSA 之间的诊断性能可比性。
CEUS 显示 17 例延迟性脾损伤并发症，122 例患者未怀疑有并发症。在这 17 例患者中，CECT 诊断出 16 例延迟性脾损伤并发症，并在另一名患者中显示出小的 DSVI。总共 122 次随访 CT 扫描均为阴性。CEUS 和 CECT 的诊断可比性为 98.6%。与 DSA 相比，CEUS 的灵敏度为 100%，阳性预测值为 91.7%。
CEUS 可用于脾损伤随访，替代 CECT。阳性 CEUS 检查可进行 CECT，并在必要时进行 DSA，以确认和治疗脾损伤并发症。
