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+
New
Wireless Handheld Ultrasound System
TE Air
New
Color Doppler Ultrasound System
KC20
New
X-Ray Detector
FDR-D-EVO III
Latest Ultrasound News
- Diagnostic System Automatically Analyzes TTE Images to Identify Congenital Heart Disease
- Super-Resolution Imaging Technique Could Improve Evaluation of Cardiac Conditions
- First AI-Powered POC Ultrasound Diagnostic Solution Helps Prioritize Cases Based On Severity
- 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
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
Low-Cost Whole-Body MRI Device Combined with AI Generates High-Quality Results
Magnetic Resonance Imaging (MRI) has significantly transformed healthcare, providing a noninvasive, radiation-free method for detailed imaging. It is especially promising for the future of medical diagnosis... Read more
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
Nuclear Medicine
view channel
New PET Biomarker Predicts Success of Immune Checkpoint Blockade Therapy
Immunotherapies, such as immune checkpoint blockade (ICB), have shown promising clinical results in treating melanoma, non-small cell lung cancer, and other tumor types. However, the effectiveness of these... Read more![Image: Whole-body maximum-intensity projections over time after [68Ga]Ga-DPI-4452 administration (Photo courtesy of SNMMI)](https://globetechcdn.com/mobile_medicalimaging/images/stories/articles/article_images/2024-05-09/JNM May 2024 Hofman.jpg "Image: Whole-body maximum-intensity projections over time after [68Ga]Ga-DPI-4452 administration (Photo courtesy of SNMMI)"){kind=small}
New PET Agent Rapidly and Accurately Visualizes Lesions in Clear Cell Renal Cell Carcinoma Patients
Clear cell renal cell cancer (ccRCC) represents 70-80% of renal cell carcinoma cases. While localized disease can be effectively treated with surgery and ablative therapies, one-third of patients either... Read more
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 moreGeneral/Advanced Imaging
view channel
Bone Density Test Uses Existing CT Images to Predict Fractures
Osteoporotic fractures are not only devastating and deadly, especially hip fractures, but also impose significant costs. They rank among the top chronic diseases in terms of disability-adjusted life years... Read more
AI Predicts Cardiac Risk and Mortality from Routine Chest CT Scans
Heart disease remains the leading cause of death and is largely preventable, yet many individuals are unaware of their risk until it becomes severe. Early detection through screening can reveal heart issues,... 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
