Does contrast-enhanced ultrasound have a role in evaluation and management of pediatric renal trauma? A preliminary experience
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In brief
In brief
This preliminary study evaluates contrast-enhanced ultrasound (CEUS) as a radiation-sparing alternative to CT for pediatric renal trauma assessment. In 7 patients, CEUS successfully monitored injury progression and guided conservative management, suggesting it may reduce radiation exposure in stable pediatric trauma patients.
Written by the GCMD Library team from the article.
Abstract
Background
To report our initial experience using intravenous contrast-enhanced ultrasound (CEUS) in pediatric renal trauma with the potential for substantial radiation reduction.
Methods
A retrospective review of all patients who underwent intravenous CEUS at our institution between May 2015 and January 2018 for the suspicion of blunt renal trauma. CEUS was obtained either as an immediate or short-term comparison to contrast-enhanced computed tomography (CECT), or in outpatient follow-up.
Results
CEUS was performed on 7 patients (9 kidneys) with age range 2 months to 16 years old. CEUS was utilized as a comparison to CECT in 4 of 7 patients for initial evaluation, clinical change, or short-term follow-up. CEUS alone was used in one patient with low suspicion for renal injury. In the remaining two patients, CEUS was obtained as a follow-up study weeks after the initial CECT, following conservative management. All patients with confirmed renal injury by CECT (n = 5) underwent a follow-up CEUS at 1–2 months.
Conclusions
In an era of conservative management for renal trauma in which operative intervention is dictated more often by the clinical course than radiographic findings, it is reasonable to consider alternative imaging methods such as CEUS in stable patients to decrease radiation exposure.
Level of Evidence Rating
IV