Usefulness of Contrast Enhanced Ultrasound for the evaluation of blunt abdominal trauma

Abstract

Blunt abdominal trauma is more and more frequent in daily practice. Contrast computer tomography is the gold-standard method for the assessment of this kind of patients, but it is not always available and it is irradiant. Also, in most cases, solid organ injuries secondary to blunt abdominal trauma are absent or mild, and the most affected patients are young and healthy (often children or teenagers), so a new performant method, that could avoid radiation exposure, is  required. Such a method is contrast enhanced ultrasonography, very sensitive for the detection of small quantities of ultrasound contrast, due to the dedicated software of the US machine, able to detect and amplify the signal generated by a very small number of microbubbles. This is the typical case of hypovascular, slow blood flow areas, edging the lacerations caused by trauma, as well as the contusion areas, where the blood flow is hampered by the presence of edema. Also, the liver, spleen and kidneys are richly vascularized, so they show intense enhancement following the injection of US contrast agents. Posttraumatic lesions being hypovascular (contusion) or avascular (ruptures, hematomas), will be revealed after contrast, clearly appearing as hypo- or unenhancing areas, as compared to the surrounding tissues.Although the use of US contrast agents is still "off-label" for the assessment of BAT, recent studies have confirmed their utility for the diagnosis of posttraumatic lesions in parenchymal organs, both in adults and in children.

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