THE IMPORTANCE OF ULTRASOUND AND MULTISPIRAL COMPUTED TOMOGRAPHY IN THE DIAGNOSIS OF ABDOMINAL TRAUMA

 

Shavrina N.V., Yartsev P.A., Khamidova L.T., Staleva K.V., Tsuleiskiri B.T.,

Teterin Yu.S., Zhigalova M.S., Rogal M.M.

 

N.V. Sklifosovsky Federal Research Institute of Emergency Medicine. Moscow, Russia.

T

o determine the comparative informativeness of radiological methods (ultrasound, multislice computed tomography) in the diagnosis of various types of injuries in patients with abdominal trauma on the early stages.

Materials and methods. The prospective study included 59 patients hospitalized at the Sklifosovsky Scientific Research Institute of emergency ambulance with abdominal trauma from 2022 to 2024. Injuries to internal organs were verified intraoperatively and/or based on instrumental data.

Criteria for inclusion in the study: patients from 18 to 90 years old with abdominal trauma, ultrasound diagnostics and MSCT at the preoperative stage.

All patients underwent ultrasound and MSCT in the first hours of hospitalization, on an emergency basis without prior preparation. During the study, the following indicators were assessed: the presence of free fluid in the abdominal cavity, its nature, changes in the amount over time, the state of the structure of parenchymal and hollow organs, retroperitoneal space, changes in dynamics, assessment of vascularization of hematomas, signs of ongoing bleeding.

Results. Analysis of retrospective data made it possible to establish that the sensitivity of ultrasound in detecting free fluid was 90% [76-92%], the specificity was 96% [86-90%], the sensitivity of the MSCT method was 83% [60-86%], the specificity was 97% [90-99%]. The sensitivity of ultrasound in detecting liver injury was 72% [46-82%], the specificity was 98% [92-99%], the sensitivity of the MSCT method was 85% [61-91%], the specificity was 98% [91- 99%]. The sensitivity of ultrasound in detecting splenic damage was 84% [61-91%], the specificity was 98% [92-99%], the sensitivity of the MSCT method was 99% [93-100%], the specificity was 98% [93-99%]. The sensitivity of ultrasound in detecting trauma was 52% [16-58%], the specificity was 98% [94-99%], the sensitivity of the MSCT method was 83% [42-98%], the specificity was 98% [93-99%]. The MSCT method also showed higher sensitivity values in detecting retroperitoneal hematomas – 93% [73-99%], specificity 98% [95-99%], sensitivity of ultrasound was 73% [52-78%], specificity 98% [94- 99%]. According to the results of the study, the ultrasound method showed low information content in the diagnosis of trauma to the intestine and mesentery, its sensitivity was 26% [10-39%], specificity 98% [95-99%], sensitivity of the MSCT method 65% [19-81%], specificity 98% [93-99%].

Conclusions. According to the presented data, the ultrasound method showed higher sensitivity in identifying and dynamically assessing hemoperitoneum and is an important stage in the clinical diagnostic algorithm for examining patients with abdominal trauma and justifying active-wait-and-see treatment tactics. The diagnostic capabilities of MSCT make it possible to use it for the initial assessment of damage to parenchymal organs and retroperitoneal hematoma. Both methods showed low sensitivity in diagnosing intestinal and mesenteric injuries.

 

Keywords: abdominal trauma, ultrasound diagnostics, multislice computed tomography, comparative information content.

 


Corresponding author: Shavrina N.V e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript

 

For citation: Shavrina N.V., Yartsev P.A., Khamidova L.T., Staleva K.V., Tsuleiskiri B.T., Teterin Yu.S., Zhigalova M.S., Rogal M.M. The importance of ultrasound and multispiral computed tomography in the diagnosis of abdominal trauma. REJR 2024; 14(4):122-131. DOI: 10.21569/2222-7415-2024-14-4-122-131.

Received:        04.06.24                 Accepted: 10.10.24