Power Doppler ultrasonography: alternative to computed tomography in abdominal trauma patients

The aim of this study was to determine if power Doppler ultrasonography, contrast enhanced when necessary, can be used as an alternative to computed tomography in the diagnosis of trauma-related organ rupture or hematoma. Fifteen patients who had sustained abdominal trauma but who had normal results on B-mode scans were included in the study. Twenty organs (13 livers and 7 spleens) were examined with both contrast-enhanced computed tomography and power Doppler ultrasonography in a blinded fashion. Ultrasonographic contrast was used in five patients. Lack of contrast enhancement (computed tomography) or lack of color in power color Doppler ultrasonography in all or part of the organ was taken as a sign of rupture or hematoma. Five ruptures were detected with both modalities (two hepatic and three splenic). Thus, ultrasonography showed no false-positive or false-negative studies when compared to the computed tomographic results. No significant difference was found in the estimated size of the damaged area between the two types of investigation. The study indicates that power color Doppler ultrasonography may be considered an alternative when a computed tomographic scan of a trauma patient is impossible.