CEUS in Blunt Abdominal Trauma in Children: Indications and EFSUMB Protocol
Clinical Indications
CEUS in blunt abdominal trauma in children is used to visualize parenchymal organ injuries. In publications on which the EFSUMB recommendations (Update 2017) are based, the method is described for trauma diagnosis, technique description, and image review (Cokkinos DD et al., Ultraschall in Med 2012). The role of CEUS in diagnosis, management, and monitoring of post-traumatic hepatic and splenic pseudoaneurysms in children is highlighted separately (Durkin N, Deganello A, Sellars ME et al., J Pediatr Surg 2016).
Scope of Application in Children
According to the sources, the liver and spleen are the primary objects of assessment in trauma. CEUS is used for both initial evaluation of injuries and subsequent follow-up screening of post-traumatic pseudoaneurysms (Durkin N et al., 2016). A multicenter study of CEUS application in abdominal trauma also confirms the role of the method (Catalano O, Aiani L, Barozzi L et al., Abdom Imaging 2009).
Examination Protocol
A detailed step-by-step EFSUMB/ESPR protocol is not provided in the supplied fragments — [to be clarified]. Sources indicate description of CEUS technique in blunt abdominal trauma (Cokkinos DD et al., Ultraschall in Med 2012); however, specific parameters (contrast dosage, mechanical index, phase timing) are absent from the fragments — [to be clarified].
Contrast Agent Safety
Safety data on second-generation ultrasound contrast agents in children were obtained, in particular, during contrast-enhanced voiding urosonography (Papadopoulou F, Ntoulia A, Siomou E, Darge K, Pediatr Radiol 2014; prospective safety evaluation in 1010 children). Specific safety indicators for intravenous administration in the context of trauma are not detailed in the fragments — [to be clarified].
Frequently asked questions
Which organs are assessed on CEUS in children with abdominal trauma?
According to EFSUMB sources, the primary objects are the liver and spleen, including diagnosis and monitoring of post-traumatic pseudoaneurysms of these organs.
Can CEUS be used for monitoring of pseudoaneurysms?
Yes, CEUS is described for diagnosis, management, and subsequent follow-up screening of post-traumatic hepatic and splenic pseudoaneurysms in children (Durkin N et al., 2016).
Is there safety data on contrast agents in children?
Safety of second-generation ultrasound contrast has been prospectively evaluated in 1010 children during urosonography (Papadopoulou F et al., 2014); data specific to trauma are not detailed in the fragments.
Where is the CEUS technique in abdominal trauma described?
Technique and image review are described in Cokkinos DD et al. (Ultraschall in Med 2012), which is referenced in the EFSUMB Update 2017 recommendations.