Contrast-Enhanced Ultrasound of the Injured Spleen After Embolization - Comparison with Computed Tomography

Purpose: The aim of this study was to compare the diagnostic performance of contrast-enhanced ultrasound (CEUS) to computed tomography (CT) in trauma patients after splenic embolization. Materials and Methods: 22 patients (17 male and 5 female) with a mean age of 32 (15 - 57 years) were studied with ultrasound (US), CEUS and CT in 23 early follow-up examinations 5 days (range: 0-12 days) after intervention and 17 late follow-up examinations 69 days (range: 52 - 189 days) after intervention. Perisplenic fluid, hematoma, laceration, infarction, scars and injury grade were evaluated. US and CEUS readings were performed independently by two radiologist, blinded to the CT results. Results: The sensitivity and specificity for CEUS at early follow-up were 85% and 70% for perisplenic fluid, 80% and 94% for subcapsular hematomas, 83% and 73% or lacerations and 75% and 87% for infarctions, respectively. The sensitivity and specificity at late follow-up were 60% and 100% for subcapsular hematomas, 91% and 67% for intrasplenic hematomas, 100% and 93% for lacerations and 89% and 100% for scars, respectively. The overall sensitivity and specificity for all lesions were 87% and 88% at early follow-up (n=138) and 85% and 95% at late follow-up (n=102), respectively. Compared to CT, CEUS underestimated the injury grade in 2/40 cases and overestimated the injury grade in 3/40 cases. Conclusion: CEUS is a useful tool for the detection of post-traumatic lesions. It is comparable to CT in follow-up after splenic embolization and may replace CT in follow-up studies.