Pediatric Abdominal Trauma Ultrasound Holds No Benefit
|
By MedImaging International staff writers Posted on 06 Jul 2017 |
|
A new study concludes that in children with blunt torso trauma, focused assessment with sonography does not improve clinical care, reduce computed tomography (CT) scans, or help identify missed intra-abdominal injuries.
Researchers at the University of California Davis (UCD; Sacramento, USA) conducted a randomized clinical study involving 925 hemodynamically stable children and adolescents with blunt torso trauma who were evaluated in the emergency department (ED). Patients were assigned to either standard trauma evaluation or to a focused assessment with sonography for trauma (FAST) examination by the ED physician. Outcomes included rate of abdominal computed tomographic (CT) scans in the ED, missed intra-abdominal injuries, ED length of stay, and hospital charges.
A total of 50 patients were diagnosed with intra-abdominal injuries. In the standard trauma evaluation group, 254 of 465 (54.6%) children underwent an abdominal CT; in the FAST group, 241 of 460 (52.4%) children had one. Overall, one case of missed intra-abdominal injury occurred in a patient in the FAST group and none in the control group. The mean ED length of stay was 6.03 hours in the FAST group and 6.07 hours in the standard care group. Median hospital charges were USD 46,415 in the FAST group and USD 47,759 in the standard care group. The study was published on June 13, 2017, in the Journal of the American Medical Association (JAMA).
“While ultrasound appears to have the potential to decrease CT use in children, we wanted to determine whether it actually worked in practice,” said senior author Professor Nathan Kuppermann, MD, chair of emergency medicine at UCD. “In all of the cases where the risk was identified as low, but where CT scans were ordered anyway, we didn’t find one patient who actually had an intra-abdominal injury.”
Guidelines for FAST examination published by the American Institute of Ultrasound in Medicine (AIUM) and the American College of Emergency Physicians (ACEP) recommend evaluation of the torso for free fluid suggesting injury to the peritoneal, pericardial, and pleural cavities, particularly in cases of trauma; examination of the subxiphoid window of the heart to denote pericardial fluid; and evaluation of the lungs to identify pneumothorax.
Related Links:
University of California Davis
Researchers at the University of California Davis (UCD; Sacramento, USA) conducted a randomized clinical study involving 925 hemodynamically stable children and adolescents with blunt torso trauma who were evaluated in the emergency department (ED). Patients were assigned to either standard trauma evaluation or to a focused assessment with sonography for trauma (FAST) examination by the ED physician. Outcomes included rate of abdominal computed tomographic (CT) scans in the ED, missed intra-abdominal injuries, ED length of stay, and hospital charges.
A total of 50 patients were diagnosed with intra-abdominal injuries. In the standard trauma evaluation group, 254 of 465 (54.6%) children underwent an abdominal CT; in the FAST group, 241 of 460 (52.4%) children had one. Overall, one case of missed intra-abdominal injury occurred in a patient in the FAST group and none in the control group. The mean ED length of stay was 6.03 hours in the FAST group and 6.07 hours in the standard care group. Median hospital charges were USD 46,415 in the FAST group and USD 47,759 in the standard care group. The study was published on June 13, 2017, in the Journal of the American Medical Association (JAMA).
“While ultrasound appears to have the potential to decrease CT use in children, we wanted to determine whether it actually worked in practice,” said senior author Professor Nathan Kuppermann, MD, chair of emergency medicine at UCD. “In all of the cases where the risk was identified as low, but where CT scans were ordered anyway, we didn’t find one patient who actually had an intra-abdominal injury.”
Guidelines for FAST examination published by the American Institute of Ultrasound in Medicine (AIUM) and the American College of Emergency Physicians (ACEP) recommend evaluation of the torso for free fluid suggesting injury to the peritoneal, pericardial, and pleural cavities, particularly in cases of trauma; examination of the subxiphoid window of the heart to denote pericardial fluid; and evaluation of the lungs to identify pneumothorax.
Related Links:
University of California Davis
Gold Member
Solid State Kv/Dose Multi-Sensor
AGMS-DM+
Silver Member
Mobile X-Ray Barrier
Lead Acrylic Mobile X-Ray Barriers
Ultrasound Needle Guide
Ultra-Pro II
New
Digital Radiography Generator
meX+20BT lite
Latest Ultrasound News
- Largest Model Trained On Echocardiography Images Assesses Heart Structure and Function
- Groundbreaking Technology Enables Precise, Automatic Measurement of Peripheral Blood Vessels
- Deep Learning Advances Super-Resolution Ultrasound Imaging
- Novel Ultrasound-Launched Targeted Nanoparticle Eliminates Biofilm and Bacterial Infection
- AI-Guided Ultrasound System Enables Rapid Assessments of DVT
- Focused Ultrasound Technique Gets Quality Assurance Protocol
- AI-Guided Handheld Ultrasound System Helps Capture Diagnostic-Quality Cardiac Images
- Non-Invasive Ultrasound Imaging Device Diagnoses Risk of Chronic Kidney Disease
- Wearable Ultrasound Platform Paves Way for 24/7 Blood Pressure Monitoring On the Wrist
- Diagnostic Ultrasound Enhancing Agent to Improve Image Quality in Pediatric Heart Patients
- AI Detects COVID-19 in Lung Ultrasound Images
- New Ultrasound Technology to Revolutionize Respiratory Disease Diagnoses
- Dynamic Contrast-Enhanced Ultrasound Highly Useful For Interventions
- Ultrasensitive Broadband Transparent Ultrasound Transducer Enhances Medical Diagnosis
- Artificial Intelligence Detects Heart Defects in Newborns from Ultrasound Images
- Ultrasound Imaging Technology Allows Doctors to Watch Spinal Cord Activity during Surgery
Channels
Radiography
view channel
Novel Breast Imaging System Proves As Effective As Mammography
Breast cancer remains the most frequently diagnosed cancer among women. It is projected that one in eight women will be diagnosed with breast cancer during her lifetime, and one in 42 women who turn 50... Read more
AI Assistance Improves Breast-Cancer Screening by Reducing False Positives
Radiologists typically detect one case of cancer for every 200 mammograms reviewed. However, these evaluations often result in false positives, leading to unnecessary patient recalls for additional testing,... Read more
MRI
view channel
World's First Whole-Body Ultra-High Field MRI Officially Comes To Market
The world's first whole-body ultra-high field (UHF) MRI has officially come to market, marking a remarkable advancement in diagnostic radiology. United Imaging (Shanghai, China) has secured clearance from the U.... Read more
World's First Sensor Detects Errors in MRI Scans Using Laser Light and Gas
MRI scanners are daily tools for doctors and healthcare professionals, providing unparalleled 3D imaging of the brain, vital organs, and soft tissues, far surpassing other imaging technologies in quality.... Read more
Diamond Dust Could Offer New Contrast Agent Option for Future MRI Scans
Gadolinium, a heavy metal used for over three decades as a contrast agent in medical imaging, enhances the clarity of MRI scans by highlighting affected areas. Despite its utility, gadolinium not only... Read more.jpg "Image: The emerging role of MRI alongside PSA testing is redefining prostate cancer diagnostics (Photo courtesy of 123RF)")
Combining MRI with PSA Testing Improves Clinical Outcomes for Prostate Cancer Patients
Prostate cancer is a leading health concern globally, consistently being one of the most common types of cancer among men and a major cause of cancer-related deaths. In the United States, it is the most... Read moreNuclear Medicine
view channel
New Imaging Technique Monitors Inflammation Disorders without Radiation Exposure
Imaging inflammation using traditional radiological techniques presents significant challenges, including radiation exposure, poor image quality, high costs, and invasive procedures. Now, new contrast... Read more
New SPECT/CT Technique Could Change Imaging Practices and Increase Patient Access
The development of lead-212 (212Pb)-PSMA–based targeted alpha therapy (TAT) is garnering significant interest in treating patients with metastatic castration-resistant prostate cancer. The imaging of 212Pb,... Read more
New Radiotheranostic System Detects and Treats Ovarian Cancer Noninvasively
Ovarian cancer is the most lethal gynecological cancer, with less than a 30% five-year survival rate for those diagnosed in late stages. Despite surgery and platinum-based chemotherapy being the standard... Read more
AI System Automatically and Reliably Detects Cardiac Amyloidosis Using Scintigraphy Imaging
Cardiac amyloidosis, a condition characterized by the buildup of abnormal protein deposits (amyloids) in the heart muscle, severely affects heart function and can lead to heart failure or death without... Read moreGeneral/Advanced Imaging
view channel
Radiation Therapy Computed Tomography Solution Boosts Imaging Accuracy
One of the most significant challenges in oncology care is disease complexity in terms of the variety of cancer types and the individualized presentation of each patient. This complexity necessitates a... Read more
PET Scans Reveal Hidden Inflammation in Multiple Sclerosis Patients
A key challenge for clinicians treating patients with multiple sclerosis (MS) is that after a certain amount of time, they continue to worsen even though their MRIs show no change. A new study has now... Read more
Imaging IT
view channel
New Google Cloud Medical Imaging Suite Makes Imaging Healthcare Data More Accessible
Medical imaging is a critical tool used to diagnose patients, and there are billions of medical images scanned globally each year. Imaging data accounts for about 90% of all healthcare data1 and, until... Read more
Global AI in Medical Diagnostics Market to Be Driven by Demand for Image Recognition in Radiology
The global artificial intelligence (AI) in medical diagnostics market is expanding with early disease detection being one of its key applications and image recognition becoming a compelling consumer proposition... Read more
Industry News
view channel
Hologic Acquires UK-Based Breast Surgical Guidance Company Endomagnetics Ltd.
Hologic, Inc. (Marlborough, MA, USA) has entered into a definitive agreement to acquire Endomagnetics Ltd. (Cambridge, UK), a privately held developer of breast cancer surgery technologies, for approximately... Read more
Bayer and Google Partner on New AI Product for Radiologists
Medical imaging data comprises around 90% of all healthcare data, and it is a highly complex and rich clinical data modality and serves as a vital tool for diagnosing patients. Each year, billions of medical... Read more
