COMPARATIVE ROLE AND EVALUATION OF ULTRASOUND AND MULTISLICE COMPUTED TOMOGRAPHY IN THE GRADING OF HEMOPERITONEUM IN PATIENTS WITH ACUTE BLUNT ABDOMINAL TRAUMA AND ITS CORRELATION WITH THE GRADING OF ORGAN INJURY
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2015, Vol 4, Issue 46
Abstract
[b] AIMS AND OBJECTIVES:[/b] 1. To assess the role of Ultrasound (US) and Multislice Computed Tomography (MSCT) in detecting hemoperitoneum in patients with acute blunt abdominal trauma. 2. To study the use of US and MSCT in grading of hemoperitoneum in blunt abdominal trauma patients. 3. To compare the US and MSCT grading of hemoperitoneum with the grading of organ injury.4. To compare and statistically analyze the spectrum of findings observed in each modality. [b]MATERIAL AND METHODS[/b]: The study was conducted at advanced diagnostics and institute of imaging, Amritsar. The study comprised of 50 patients who were stable enough to undergo both US and CT scans.US was preceded by MSCT in most of the patients and the time gap between the imaging modalities was less than 1 hour to make the study comparable. [b]TECHNIQUES ADOPTED: [/b]1. US was performed on Versa plus (Siemens) and Xario (Toshiba) with Cardiac, 3.5-5 Mhz-Convex and 5-7.5 Mhz-Linear probes. Particular attention was paid to the amount of free fluid in the abdomen and pelvis. 2. MSCT was performed with MSCT Volume Zoom (Siemens Forchheim Germany AG). 500-1000cc of water orally or through nasogastric tube was given 15-20 minutes before the study, followed by 120cc I/V contrast at the rate of 2-3ml/second using power injector. Parameters used: Single breath hold; A. 165 mAs. B. 120 kvp. C. Scan delay-40 seconds. D. Collimation-4x2.5mm. E. Pitch-5mm. Following findings were observed: a. Presence of peritoneal fluid. B. Any tear or hematoma in the solid abdominal organs like spleen and liver. C. Status of hollow viscera like small bowel, large bowel and urinary bladder. Hemoperitoneum was scored on both US and MSCT. Visceral injuries were graded according to O.I.S grading system. Score was correlated with the underlying organ injury and the management of the patient. US scoring (Table A) and MSCT quantification of hemoperitoneum was done. (Table B) Location of hemoperitoneum. A. Perisplenic space. B. Perihepatic space. C. Morison’s pouch. D. Left paracolic gutter. E. Cul-de-sac in pelvis. Data analysis was done using stasticial package (Analyse it Leeds U.K.). Sensitivity and specificity of each modality was observed along with cost analysis. Chi square test was performed to determine the statistical significance of the above results followed by ROC analysis to compare the sensitivity and specificity of both the modalities.
Authors and Affiliations
Kunwarpal Singh, Sukhdeep Kaur, Thukral C. L. , Amandeep Singh, Harmeet Kaur, Sonali
Keywords
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- EP ID EP90261
- DOI 10.14260/jemds/2015/1156
- Views 98
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