Role of Comparison between Ultrasound and Computed Tomography in Evaluating Splenic Trauma

Abstract

Abstract

Background & Aim: The aim of this study is to evaluate the role of ultrasound in the investigation of spleen traumatic injuries, with or without free fluid within the peritoneum, in comparison with a CT scan or a surgery as two final criteria for diagnosis.

The study was prospective and was conducted over a period of approximately one year (June 2019 - May 2020) in the emergency departments of Al-Mouwasat University Hospital and University Children's Hospital, and it was conducted on abdominal trauma patients of all ages (children or adults) who underwent a CT scan of the abdomen and / or surgery.

Materials & Methods: The study was conducted by means of the available devices (EDAN U2) and (Philips ENVISOR C HD), using a transducer frequency of 3.5 MHz. The examination used to take an average of 5-10 minutes, in which free fluid was searched in Morrison's pouch, the area around the liver, the area around the spleen, the paracolic gutters and in Douglas's diverticulum, and the area behind the peritoneum was examined to check fluid pools, then spleen damage. The results were recorded before performing a CT scan of the abdomen and pelvis.

CT was performed with the TOSHIBA Asteion, on average 30 minutes after the ultrasound. The adopted protocol was: the thickness of the section is from 5 mm to 7 mm and the table speed is 5 mm / s. The sections are taken from the bases of the lungs to the pelvis after administering intravenous contrast media +/- orally (in certain cases), and the axial stratum was read without knowledge of the US result. The sample size is 205 patients; They were divided between 141 males and 64 females.

Results: It was found that splenic injuries were the most frequent - as reported in the medical literature - but splenic lesions were largely overlooked (sensitivity ~ 34%). The sensitivity did not increase significantly (sensitivity ~ 66%) although the CT scan result was later learned by the examiner.

Concluion: Our study concluded that ultrasound scan is limited in effectiveness - due to its lack of sensitivity - in detecting spleen damage. This limitation is caused by the examination technique and not by the examiner or the circumstances surrounding the examination.