Skip to main content
Top

13-10-2023 | Abdominal Trauma | Original Article

Contrast-enhanced ultrasound (CEUS) in the follow-up of abdominal solid organ trauma: an international survey prior to the PseAn study

Authors: Giuliano Santolamazza, Francesco Virdis, Fikri Abu-Zidan, Stefano Piero Bernardo Cioffi, Elisa Reitano, Michele Altomare, Roberto Bini, Andrea Spota, Mauro Podda, Jayant Kumar, Osvaldo Chiara, Stefania Cimbanassi, PseAn Collaborative Group

Published in: European Journal of Trauma and Emergency Surgery

Login to get access

Abstract

Background

The blunt and penetrating abdominal trauma follow-up relies on contrast CT scan to detect solid organ injuries. CEUS is not widely used worldwide, despite its accuracy and feasibility in identifying parenchymal and vascular lesions. This survey aims to define the current use of CEUS in Trauma Centers and the expectations of Emergency Surgeons regarding its role.

Methods

We sent an online questionnaire composed of 10 questions to trauma physicians worldwide during the period of September 2022 to March 2023.

Results

59 participants from 53 different centers answered the questionnaire. 76.2% of the enrolled participants have CEUS available at their Institution, and 49.2% think that it can replace CT scan. Contrast-CT scan remains the preferred option in the follow-up of blunt liver (69.5%), spleen (72.9%) and kidney (76.3%) injuries, followed by CEUS which is used in 18.6% for liver, 20.3% for spleen and 15.3% for kidney injuries. The results are similar for penetrating abdominal trauma, with contrast CT scan being the first-line imaging technique (91.5% for liver, 91.5% for spleen and 88.1% for kidney injuries), followed by CEUS (5.1% for liver, 5.1% for spleen and 6.8% for kidney injuries).

Conclusions

Our survey shows that CEUS is still underutilized in the follow-up of abdominal trauma, even though many emergency surgeons consider it as a valid alternative to contrast CT scan.
Appendix
Available only for authorised users
Literature
1.
go back to reference Weinberg JA, Magnotti LJ, Croce MA, et al. The utility of serial computed tomography imaging of blunt splenic injury: still worth a second look? J Trauma 2007;62(5):1143–7; discussion 1147–1148. Weinberg JA, Magnotti LJ, Croce MA, et al. The utility of serial computed tomography imaging of blunt splenic injury: still worth a second look? J Trauma 2007;62(5):1143–7; discussion 1147–1148.
2.
3.
go back to reference Skattum J, Naess PA, Eken T, Gaarder C. Refining the role of splenic angiographic embolization in high-grade splenic injuries. J Trauma Acute Care Surg. 2013;74(1):100–3; discussion 103–104. Skattum J, Naess PA, Eken T, Gaarder C. Refining the role of splenic angiographic embolization in high-grade splenic injuries. J Trauma Acute Care Surg. 2013;74(1):100–3; discussion 103–104.
4.
go back to reference Cimbanassi S, Chiara O, Leppaniemi A, et al. Nonoperative management of abdominal solid-organ injuries following blunt trauma in adults: results from an International Consensus Conference. J Trauma Acute Care Surg marzo. 2018;84(3):517–31.CrossRef Cimbanassi S, Chiara O, Leppaniemi A, et al. Nonoperative management of abdominal solid-organ injuries following blunt trauma in adults: results from an International Consensus Conference. J Trauma Acute Care Surg marzo. 2018;84(3):517–31.CrossRef
5.
go back to reference Schwarze V, Lindner F, Marschner C, et al. Single-center study: The diagnostic performance of contrast-enhanced ultrasound (CEUS) for assessing focal splenic lesions compared to CT and MRI. Clin Hemorheol Microcirc. 2019;73(1):65–71.CrossRefPubMed Schwarze V, Lindner F, Marschner C, et al. Single-center study: The diagnostic performance of contrast-enhanced ultrasound (CEUS) for assessing focal splenic lesions compared to CT and MRI. Clin Hemorheol Microcirc. 2019;73(1):65–71.CrossRefPubMed
6.
go back to reference Atri M, Jang HJ, Kim TK, Khalili K. Contrast-enhanced US of the Liver and Kidney: a Problem-solving Modality. Radiology. 2022;303(1):11–25.CrossRefPubMed Atri M, Jang HJ, Kim TK, Khalili K. Contrast-enhanced US of the Liver and Kidney: a Problem-solving Modality. Radiology. 2022;303(1):11–25.CrossRefPubMed
7.
go back to reference Ladam-Marcus V, Mac G, Job L, et al. [Contrast-enhanced ultrasound and liver imaging: review of the literature]. J Radio 2009;90(1 Pt 2):93–106; quiz 107–8. Ladam-Marcus V, Mac G, Job L, et al. [Contrast-enhanced ultrasound and liver imaging: review of the literature]. J Radio 2009;90(1 Pt 2):93–106; quiz 107–8.
8.
go back to reference Didier RA, Biko DM, Hwang M, et al. Emerging contrast-enhanced ultrasound applications in children. Pediatr Radiol. 2021;51(12):2418–24.CrossRefPubMed Didier RA, Biko DM, Hwang M, et al. Emerging contrast-enhanced ultrasound applications in children. Pediatr Radiol. 2021;51(12):2418–24.CrossRefPubMed
9.
go back to reference Sidhu PS, Cantisani V, Dietrich CF, et al. The EFSUMB Guidelines and Recommendations for the Clinical Practice of Contrast-Enhanced Ultrasound (CEUS) in Non-Hepatic Applications: Update 2017 (Long Version). Ultraschall Med. 2018;39(2):e2-44.CrossRefPubMed Sidhu PS, Cantisani V, Dietrich CF, et al. The EFSUMB Guidelines and Recommendations for the Clinical Practice of Contrast-Enhanced Ultrasound (CEUS) in Non-Hepatic Applications: Update 2017 (Long Version). Ultraschall Med. 2018;39(2):e2-44.CrossRefPubMed
10.
go back to reference El-Bandar N, Lerchbaumer MH, Peters R, et al. Kidney Perfusion in Contrast-Enhanced Ultrasound (CEUS) Correlates with Renal Function in Living Kidney Donors. J Clin Med. 2022;11(3):791.CrossRefPubMedPubMedCentral El-Bandar N, Lerchbaumer MH, Peters R, et al. Kidney Perfusion in Contrast-Enhanced Ultrasound (CEUS) Correlates with Renal Function in Living Kidney Donors. J Clin Med. 2022;11(3):791.CrossRefPubMedPubMedCentral
11.
go back to reference Franke D, Daugherty RJ, Ključevšek D, et al. Contrast-enhanced ultrasound of transplant organs - liver and kidney - in children. Pediatr Radiol. 2021;51(12):2284–302.CrossRefPubMedPubMedCentral Franke D, Daugherty RJ, Ključevšek D, et al. Contrast-enhanced ultrasound of transplant organs - liver and kidney - in children. Pediatr Radiol. 2021;51(12):2284–302.CrossRefPubMedPubMedCentral
12.
go back to reference Como G, Montaldo L, Baccarani U, et al. Contrast-enhanced ultrasound applications in liver transplant imaging. Abdom Radiol (NY). 2021;46(1):84–95.CrossRefPubMed Como G, Montaldo L, Baccarani U, et al. Contrast-enhanced ultrasound applications in liver transplant imaging. Abdom Radiol (NY). 2021;46(1):84–95.CrossRefPubMed
13.
go back to reference Goh Y, Neo WT, Teo YM, et al. Role of contrast-enhanced ultrasound in the evaluation of post-liver transplant vasculature. Clin Radiol. 2020;75(11):832–44.CrossRefPubMed Goh Y, Neo WT, Teo YM, et al. Role of contrast-enhanced ultrasound in the evaluation of post-liver transplant vasculature. Clin Radiol. 2020;75(11):832–44.CrossRefPubMed
14.
go back to reference Valentino M, Serra C, Pavlica P, et al. Blunt abdominal trauma: diagnostic performance of contrast-enhanced US in children–initial experience. Radiology. 2008;246(3):903–9.CrossRefPubMed Valentino M, Serra C, Pavlica P, et al. Blunt abdominal trauma: diagnostic performance of contrast-enhanced US in children–initial experience. Radiology. 2008;246(3):903–9.CrossRefPubMed
15.
go back to reference Miele V, Piccolo CL, Sessa B, et al. Comparison between MRI and CEUS in the follow-up of patients with blunt abdominal trauma managed conservatively. Radiol Med. 2016;121(1):27–37.CrossRefPubMed Miele V, Piccolo CL, Sessa B, et al. Comparison between MRI and CEUS in the follow-up of patients with blunt abdominal trauma managed conservatively. Radiol Med. 2016;121(1):27–37.CrossRefPubMed
16.
go back to reference Poletti PA, Becker CD, Arditi D, et al. Blunt splenic trauma: can contrast enhanced sonography be used for the screening of delayed pseudoaneurysms? Eur J Radiol. 2013;82(11):1846–52.CrossRefPubMed Poletti PA, Becker CD, Arditi D, et al. Blunt splenic trauma: can contrast enhanced sonography be used for the screening of delayed pseudoaneurysms? Eur J Radiol. 2013;82(11):1846–52.CrossRefPubMed
17.
go back to reference Manetta R, Pistoia ML, Bultrini C, et al. Ultrasound enhanced with sulphur-hexafluoride-filled microbubbles agent (SonoVue) in the follow-up of mild liver and spleen trauma. Radiol Med. 2009;114(5):771–9.CrossRefPubMed Manetta R, Pistoia ML, Bultrini C, et al. Ultrasound enhanced with sulphur-hexafluoride-filled microbubbles agent (SonoVue) in the follow-up of mild liver and spleen trauma. Radiol Med. 2009;114(5):771–9.CrossRefPubMed
18.
go back to reference Virdis F, Cioffi SPB, Abu-Zidan F, et al. Detection of post-traumatic abdominal pseudoaneurysms by CEUS and CT: A prospective comparative global study (the PseAn study)-study protocol. Front Surg. 2023;10:1124087.CrossRefPubMedPubMedCentral Virdis F, Cioffi SPB, Abu-Zidan F, et al. Detection of post-traumatic abdominal pseudoaneurysms by CEUS and CT: A prospective comparative global study (the PseAn study)-study protocol. Front Surg. 2023;10:1124087.CrossRefPubMedPubMedCentral
19.
go back to reference Eysenbach G. Improving the quality of Web surveys: the Checklist for Reporting Results of Internet E-Surveys (CHERRIES). J Med Internet Res. 2004;6(3): e34.CrossRefPubMedPubMedCentral Eysenbach G. Improving the quality of Web surveys: the Checklist for Reporting Results of Internet E-Surveys (CHERRIES). J Med Internet Res. 2004;6(3): e34.CrossRefPubMedPubMedCentral
21.
go back to reference Kelley K, Clark B, Brown V, et al. Good practice in the conduct and reporting of survey research. Int J Qual Health Care. 2003;15(3):261–6.CrossRefPubMed Kelley K, Clark B, Brown V, et al. Good practice in the conduct and reporting of survey research. Int J Qual Health Care. 2003;15(3):261–6.CrossRefPubMed
23.
go back to reference Sawhney S, Wilson SR. Can Ultrasound With Contrast Enhancement Replace Nonenhanced Computed Tomography Scans in Patients With Contraindication to Computed Tomography Contrast Agents? Ultrasound Q. 2017;33(2):125–32.CrossRefPubMedPubMedCentral Sawhney S, Wilson SR. Can Ultrasound With Contrast Enhancement Replace Nonenhanced Computed Tomography Scans in Patients With Contraindication to Computed Tomography Contrast Agents? Ultrasound Q. 2017;33(2):125–32.CrossRefPubMedPubMedCentral
24.
go back to reference Zarzour JG, Lockhart ME, West J, et al. Contrast-Enhanced Ultrasound Classification of Previously Indeterminate Renal Lesions. J Ultrasound Med. 2017;36(9):1819–27.CrossRefPubMed Zarzour JG, Lockhart ME, West J, et al. Contrast-Enhanced Ultrasound Classification of Previously Indeterminate Renal Lesions. J Ultrasound Med. 2017;36(9):1819–27.CrossRefPubMed
25.
go back to reference Ranganath PG, Robbin ML, Back SJ, Grant EG, Fetzer DT. Practical advantages of contrast-enhanced ultrasound in abdominopelvic radiology. Abdom Radiol (NY). 2018;43(4):998–1012.CrossRefPubMed Ranganath PG, Robbin ML, Back SJ, Grant EG, Fetzer DT. Practical advantages of contrast-enhanced ultrasound in abdominopelvic radiology. Abdom Radiol (NY). 2018;43(4):998–1012.CrossRefPubMed
26.
go back to reference Cokkinos D, Antypa E, Stefanidis K, Tserotas P, Kostaras V, Parlamenti A, et al. Contrast-enhanced ultrasound for imaging blunt abdominal trauma - indications, description of the technique and imaging review. Ultraschall Med. 2012;33(1):60–7.CrossRefPubMed Cokkinos D, Antypa E, Stefanidis K, Tserotas P, Kostaras V, Parlamenti A, et al. Contrast-enhanced ultrasound for imaging blunt abdominal trauma - indications, description of the technique and imaging review. Ultraschall Med. 2012;33(1):60–7.CrossRefPubMed
27.
go back to reference Valentino M, Ansaloni L, Catena F, Pavlica P, Pinna AD, Barozzi L. Contrast-enhanced ultrasonography in blunt abdominal trauma: considerations after 5 years of experience. Radiol Med. 2009;114(7):1080–93.CrossRefPubMed Valentino M, Ansaloni L, Catena F, Pavlica P, Pinna AD, Barozzi L. Contrast-enhanced ultrasonography in blunt abdominal trauma: considerations after 5 years of experience. Radiol Med. 2009;114(7):1080–93.CrossRefPubMed
28.
go back to reference Sessa B, Trinci M, Ianniello S, Menichini G, Galluzzo M, Miele V. Blunt abdominal trauma: role of contrast-enhanced ultrasound (CEUS) in the detection and staging of abdominal traumatic lesions compared to US and CE-MDCT. Radiol Med. 2015;120(2):180–9.CrossRefPubMed Sessa B, Trinci M, Ianniello S, Menichini G, Galluzzo M, Miele V. Blunt abdominal trauma: role of contrast-enhanced ultrasound (CEUS) in the detection and staging of abdominal traumatic lesions compared to US and CE-MDCT. Radiol Med. 2015;120(2):180–9.CrossRefPubMed
29.
go back to reference Piccolo CL, Trinci M, Pinto A, Brunese L, Miele V. Role of contrast-enhanced ultrasound (CEUS) in the diagnosis and management of traumatic splenic injuries. J Ultrasound. 2018;21(4):315–27.CrossRefPubMedPubMedCentral Piccolo CL, Trinci M, Pinto A, Brunese L, Miele V. Role of contrast-enhanced ultrasound (CEUS) in the diagnosis and management of traumatic splenic injuries. J Ultrasound. 2018;21(4):315–27.CrossRefPubMedPubMedCentral
30.
go back to reference Thorelius L. Emergency real-time contrast-enhanced ultrasonography for detection of solid organ injuries. Eur Radiol. 2007;17(Suppl 6):F107-111.CrossRefPubMed Thorelius L. Emergency real-time contrast-enhanced ultrasonography for detection of solid organ injuries. Eur Radiol. 2007;17(Suppl 6):F107-111.CrossRefPubMed
31.
go back to reference Pinto F, Valentino M, Romanini L, Basilico R, Miele V. The role of CEUS in the assessment of haemodynamically stable patients with blunt abdominal trauma. Radiol Med. 2015;120(1):3–11.CrossRefPubMed Pinto F, Valentino M, Romanini L, Basilico R, Miele V. The role of CEUS in the assessment of haemodynamically stable patients with blunt abdominal trauma. Radiol Med. 2015;120(1):3–11.CrossRefPubMed
Metadata
Title
Contrast-enhanced ultrasound (CEUS) in the follow-up of abdominal solid organ trauma: an international survey prior to the PseAn study
Authors
Giuliano Santolamazza
Francesco Virdis
Fikri Abu-Zidan
Stefano Piero Bernardo Cioffi
Elisa Reitano
Michele Altomare
Roberto Bini
Andrea Spota
Mauro Podda
Jayant Kumar
Osvaldo Chiara
Stefania Cimbanassi
PseAn Collaborative Group
Publication date
13-10-2023
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Trauma and Emergency Surgery
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI
https://doi.org/10.1007/s00068-023-02364-z