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Liver trauma diagnosis with contrast-enhanced ultrasound: interobserver variability between radiologist and emergency physician in an animal study

Posted in: Emergency Medicine Clinical Studies, FAST and E-FAST|February 20, 2015
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SONOSIM SUMMARY: This study from the American Journal of Emergency Medicine sought to compare liver trauma evaluation techniques using traditional ultrasound versus contrast-enhanced ultrasound. Radiologist and emergency medicine physicians performed both conventional ultrasound and contrast-enhanced ultrasound evaluations on rabbit livers that had sustained blunt trauma. Contrast-enhanced computed tomography was used as a diagnostic gold standard. The results show that when contrast-enhanced ultrasound was used, both diagnostic sensitivity and interobserver agreement was improved, as compared to conventional ultrasound, for identifying blunt hepatic injury.
Ultrasound to detect pneumothorax, e-fast scan
You JS, Chung YE, Lee HJ, et. al. Liver trauma diagnosis with contrast-enhanced ultrasound: interobserver variability between radiologist and emergency physician in an animal study. American Journal of Emergency Medicine. 2012 Sep; 30(7): 1229-1234

Abstract

Objective

The purpose of our study was to evaluate interobserver variability between the radiologist and emergency physician in detecting blunt liver trauma by conventional and contrast-enhanced ultrasound (US) (CEUS).

Methods

We created 20 sites of blunt liver trauma in rabbits and performed conventional US and CEUS on the animals. A radiologist and an emergency physician independently evaluated the degree of liver trauma. Using contrast-enhanced computed tomography as a reference standard, the diagnostic performance of US and CEUS was calculated. Interobserver variability between radiologist and emergency physician was compared before and after contrast enhancement of US.

Results

Overall sensitivity and specificity for detecting liver trauma on conventional US, regardless of the degree of trauma, were 61.1% and 100% for the radiologist and 50% and 100% for the emergency physician. On CEUS, the sensitivity and specificity were 94.4% and 100% for both the radiologist and emergency physician. The interobserver agreement between emergency physician and radiologist increased from 0.867 to 0.955 after contrast enhancement on US.

Conclusions

Contrast-enhanced US may permit a more accurate diagnosis for liver trauma than conventional US by both the radiologist and emergency physician. Contrast-enhanced US may also reduce interobserver variability for this diagnosis.

To read the complete article, visit The American Journal of Emergency Medicine.

SonoSim Keywords: Ultrasonography, Online Ultrasound Courses, Trauma Ultrasound, FAST, EFAST, Ultrasound with Contrast, CEUS

February 14, 2017 System Administrator

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Previous Article Optic Neuritis Diagnosed by Bedside Emergency Physician-Performed Ultrasound: A Case Report Monday, October 20, 2014
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