PDF(Pubmed)
Abstract：
OBJECTIVE: Intra-abdominal injury is a major cause of morbidity in children. Computed tomography (CT) is the reference standard for the evaluation of hemodynamically stable abdominal trauma. CT has an increased risk of long-term radiation induced malignancies and a possible risk associated with the use of iodinated contrast media. Contrast-enhanced ultrasound (CEUS) might represent an alternative to CT in stable children with blunt abdominal trauma (BAT). Nonetheless, CEUS in pediatrics remains limited by the lack of strong evidence. The purpose of this study was to offer a systematic review on the use of CEUS in pediatric abdominal trauma.
METHODS: Electronic search of PubMed, EMBASE and Cochrane databases of studies investigating CEUS for abdominal trauma in children. The risk of bias was assessed using the ROBINS-I tool.
RESULTS: This systematic review included 7 studies. CEUS was performed with different ultrasound equipment, always with a curvilinear transducer. Six out of seven studies used a second-generation contrast agent. No immediate adverse reactions were reported. The dose of contrast agent and the scanning technique varied between studies. All CEUS exams were performed by radiologists, in the radiology department or at the bedside. No standard training was reported to become competent in CEUS. The range of sensitivity and specificity of CEUS were 85.7 to 100% and 89 to 100%, respectively.
CONCLUSIONS: CEUS appears to be safe and accurate to identify abdominal solid organ injuries in children with BAT. Further research is necessary to assess the feasibility of CEUS by non-radiologists, the necessary training, and the benefit-cost ratio of CEUS as a tool to potentially reduce CT scans.
METHODS: Electronic search of PubMed, EMBASE and Cochrane databases of studies investigating CEUS for abdominal trauma in children. The risk of bias was assessed using the ROBINS-I tool.
RESULTS: This systematic review included 7 studies. CEUS was performed with different ultrasound equipment, always with a curvilinear transducer. Six out of seven studies used a second-generation contrast agent. No immediate adverse reactions were reported. The dose of contrast agent and the scanning technique varied between studies. All CEUS exams were performed by radiologists, in the radiology department or at the bedside. No standard training was reported to become competent in CEUS. The range of sensitivity and specificity of CEUS were 85.7 to 100% and 89 to 100%, respectively.
CONCLUSIONS: CEUS appears to be safe and accurate to identify abdominal solid organ injuries in children with BAT. Further research is necessary to assess the feasibility of CEUS by non-radiologists, the necessary training, and the benefit-cost ratio of CEUS as a tool to potentially reduce CT scans.
摘要：
目的：腹内损伤是儿童发病的主要原因。计算机断层扫描（CT）是评估血流动力学稳定的腹部创伤的参考标准。CT具有长期辐射引起的恶性肿瘤的风险增加，并且可能与使用碘化造影剂相关。对于患有腹部钝性外伤（BAT）的稳定儿童，超声造影（CEUS）可能是CT的替代方法。尽管如此，CEUS在儿科中仍然受到缺乏有力证据的限制。这项研究的目的是对CEUS在小儿腹部创伤中的应用进行系统评价。
方法：PubMed的电子搜索，EMBASE和Cochrane数据库研究儿童腹部创伤CEUS。使用ROBINS-I工具评估偏倚风险。
结果：本系统综述包括7项研究。使用不同的超声设备进行CEUS，总是有一个曲线传感器。七项研究中有六项使用了第二代造影剂。没有立即的不良反应报告。造影剂的剂量和扫描技术在研究之间有所不同。所有的CEUS检查都是由放射科医生进行的,在放射科或床边。据报道，没有标准培训可以胜任CEUS。CEUS的敏感性和特异性分别为85.7~100%和89~100%,分别。
结论：CEUS在识别BAT患儿腹部实体器官损伤方面似乎是安全且准确的。需要进一步的研究来评估非放射科医生使用CEUS的可行性，必要的培训,以及CEUS作为潜在减少CT扫描的工具的效益成本比。
方法：PubMed的电子搜索，EMBASE和Cochrane数据库研究儿童腹部创伤CEUS。使用ROBINS-I工具评估偏倚风险。
结果：本系统综述包括7项研究。使用不同的超声设备进行CEUS，总是有一个曲线传感器。七项研究中有六项使用了第二代造影剂。没有立即的不良反应报告。造影剂的剂量和扫描技术在研究之间有所不同。所有的CEUS检查都是由放射科医生进行的,在放射科或床边。据报道，没有标准培训可以胜任CEUS。CEUS的敏感性和特异性分别为85.7~100%和89~100%,分别。
结论：CEUS在识别BAT患儿腹部实体器官损伤方面似乎是安全且准确的。需要进一步的研究来评估非放射科医生使用CEUS的可行性，必要的培训,以及CEUS作为潜在减少CT扫描的工具的效益成本比。
