Contrast-Enhanced Ultrasound for Imaging Blunt Abdominal Trauma – Indications, Description of the Technique and Imaging Review

Zusammenfassung

Patienten mit stumpfem Bauchtrauma werden zunächst mit Ultraschall (US) untersucht, um das freie Bauchwasser zu bewerten. Dabei können allerdings Verletzungen der festen Organe übersehen werden. Obwohl die Computertomografie (CT) die Goldstandardtechnik zur Darstellung von Bauchverletzungen ist, sind deren wohlbekannte Nachteile die zu häufige Anwendung, die ionisierende Strahlung, der nötige Transport des Patienten und mögliche Artefakte. Die kontrastverstärkte Ultrasonografie (CEUS) kann als bildgebendes Verfahren zwischen diesen beiden Methoden angesiedelt werden. Sie entdeckt einfach und verlässlich Verletzungen der Bauchorgane bei Patienten mit energiearmen lokalisierten Traumata und verringert die Anzahl der CT-Untersuchungen. Die Durchführung erfolgt sehr schnell am Bett des Patienten, sodass sich ein Transport erübrigt. Es gibt nur sehr wenige Kontraindikationen und äußerst selten anaphylaktoide Reaktionen. Insgesamt hat sich CEUS als sehr hilfreich bei der anfänglichen Darstellung traumatischer Läsionen von Leber, Niere und Milz sowie bei der Nachuntersuchung der Patienten erwiesen.

Abstract

Patients with blunt abdominal trauma are initially imaged with ultrasound (US) for the evaluation of free abdominal fluid. However, lacerations of solid organs can be overlooked. Although computed tomography (CT) is the gold standard technique for abdominal trauma imaging, overutilization, ionizing radiation, need to transport the patient and potential artifacts are well known disadvantages. Contrast-enhanced US (CEUS) can be used as an imaging tool between the two methods. It can easily and reliably reveal solid abdominal organ injuries in patients with low-energy localized trauma and decrease the number of CT scans performed. It can be rapidly performed at the patient’s bedside with no need for transportation. There are only very few contraindications and anaphylactoid reactions are extremely rare. Altogether, CEUS has proved to be very helpful for the initial imaging of traumatic lesions of the liver, kidney and spleen, as well as for patient follow-up.

Key words

abdomen - ultrasound - contrast agents - CEUS

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