Diagnostic performance of contrast-enhanced ultrasound in traumatic solid organ injuries in children: a systematic review and meta-analysis.

IF 2.1 3区医学 Q2 PEDIATRICS Pediatric Radiology Pub Date : 2025-02-01 Epub Date: 2024-12-13 DOI:10.1007/s00247-024-06127-9

Payam Jannatdoust, Parya Valizadeh, Amir Hassankhani, Melika Amoukhteh, Delaram J Ghadimi, Mahsa Heidari-Foroozan, Paniz Sabeghi, Paniz Adli, Jennifer H Johnston, Pauravi S Vasavada, Ali Gholamrezanezhad

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Abstract

Background: Blunt abdominal trauma (BAT) is a significant contributor to pediatric mortality, often causing liver and spleen injuries. Contrast-enhanced computed tomography (CT), the gold standard for diagnosing solid organ injury, poses radiation risks to children. Contrast-enhanced ultrasound (CEUS) may be a promising alternative imaging modality.

Objectives: To evaluate the diagnostic utility of CEUS for detecting solid organ injuries following BAT in the pediatric population.

Methods: A systematic review and meta-analysis were conducted through a thorough literature search in PubMed, Scopus, Web of Science, and Embase databases up to October 1, 2023. Diagnostic accuracy metrics were aggregated using a bivariate model, and subgroup meta-analysis compared CEUS accuracy across various organs.

Results: Meta-analysis from four studies, including 364 pediatric patients, revealed a pooled sensitivity of 88.5% (95%CI 82.5-92.6%) and specificity of 98.5% (95%CI 94.9-99.6%), with an area under the curve of 96% (95%CI 88 - 99%). Splenic injuries showed higher sensitivity than liver injuries (P-value < 0.01), while kidney assessments demonstrated higher specificity (P-value < 0.05).

Conclusion: This study highlights the diagnostic potential of CEUS for pediatric solid organ injuries caused by BAT. Further large-scale studies are needed due to the limited number and sample size of the included studies.

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对比增强超声在儿童创伤性实体器官损伤中的诊断表现：系统回顾和荟萃分析。

背景：钝性腹部创伤（BAT）是儿童死亡的重要原因，常引起肝脏和脾脏损伤。对比增强计算机断层扫描（CT）是诊断实体器官损伤的金标准，对儿童有辐射风险。对比增强超声（CEUS）可能是一种有前途的替代成像方式。目的：评价超声造影在儿科BAT术后实体器官损伤诊断中的应用价值。方法：通过全面检索PubMed、Scopus、Web of Science和Embase数据库截至2023年10月1日的文献，进行系统综述和meta分析。使用双变量模型汇总诊断准确性指标，亚组荟萃分析比较了超声造影在不同器官中的准确性。结果：对包括364例儿童患者的4项研究进行荟萃分析，结果显示，合并敏感性为88.5% (95%CI 82.5-92.6%)，特异性为98.5% (95%CI 94.9-99.6%)，曲线下面积为96% （95%CI 88 - 99%）。脾损伤敏感性高于肝损伤（p值）结论：本研究突出了超声造影对BAT所致儿童实体器官损伤的诊断潜力。由于纳入研究的数量和样本量有限，需要进一步的大规模研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric Radiology 医学-核医学

CiteScore

4.40

自引率

17.40%

发文量

300

审稿时长

3-6 weeks

期刊介绍： Official Journal of the European Society of Pediatric Radiology, the Society for Pediatric Radiology and the Asian and Oceanic Society for Pediatric Radiology Pediatric Radiology informs its readers of new findings and progress in all areas of pediatric imaging and in related fields. This is achieved by a blend of original papers, complemented by reviews that set out the present state of knowledge in a particular area of the specialty or summarize specific topics in which discussion has led to clear conclusions. Advances in technology, methodology, apparatus and auxiliary equipment are presented, and modifications of standard techniques are described. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted.