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Ultrasound with contrast for pediatrics with abdominal trauma superior to CT

by John W. Mitchell , Senior Correspondent
Results from a recent British study indicate that children who suffer from blunt abdominal injury can effectively be diagnosed and managed with contrast enhanced ultrasound (CEUS). CEUS was deemed to be a lower cost alternative to follow-up CT and did a better job of identifying traumatic parenchymal lesions on internal organs in children with blunt force trauma to the abdomen.

“We were surprised that the accuracy of the technique was so robust, with follow up of targeted organ CEUS in children becoming the normal approach in our institution,” Dr. Annmaria Deganello, a consulting pediatrics radiologist at King’s College Hospital in London and lead researcher told DOTmed News. “The results have completely altered our practices with no detrimental effect.”

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The finding is yet another recent change of practice in the ongoing effort to reduce radiation exposure in pediatric patients.

“Reduction in exposure to ionizing radiation in a young vulnerable population with the potential to reduce cancer risk; this is in line with the ALARA principle (As Low As Reasonably Achievable), which makes pediatric radiologists responsible for reducing the amount of radiation a child is exposed to, while maintaining safety and reliability of the diagnostic modality,” explained Dr. Deganello

The retro-perspective study reviewed studies of nearly 800 pediatric patients from the ages of nine months to 20 years old, conducted over a 16-year period. About 15 percent of these patients had follow-up CT studies and about a third of those patients received CEUS. This study was an extension of an earlier study to examine the use of CEUS in focal liver lesions, which Dr. Deganello said made sense, given their area of specialty focus.

“We expanded the initial study to include follow-up on blunt abdominal trauma. King’s College is a tertiary center for pediatric liver diseases and a Level I trauma center.” She added that CEUS images were “exquisitely informative.”

The King’s College study results were similar to the results of an Italian study published in March 2015. Dr. Deganello said the results of her study have not yet been published but have been presented at a recent U.S. conference and will be taught in a teaching course at the upcoming British Medical Ultrasound Conference.

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