Related Experiment Video
Updated: Apr 16, 2026
Focused Assessment with Sonography for Trauma FAST Exam: Image Acquisition
Published on: September 22, 2023
Use of Oral Contrast for Abdominal Computed Tomography in Children With Blunt Torso Trauma
Angela M Ellison1, Kimberly S Quayle2, Bema Bonsu3
1Department of Pediatrics, Perelman School of Medicine/Children's Hospital of Philadelphia, Philadelphia, PA.
Insights
Abdominal CT scans for children with blunt torso trauma show similar accuracy for detecting intra-abdominal injuries, whether or not oral contrast is used. Specificity was slightly higher with oral contrast, but overall test characteristics were comparable.
Area of Science:
- Radiology
- Pediatric Imaging
- Emergency Medicine
Background:
- Abdominal computed tomography (CT) is crucial for diagnosing intra-abdominal injuries in children with blunt torso trauma.
- The use of oral contrast in abdominal CT for pediatric patients remains variable.
- Evaluating the diagnostic performance of abdominal CT with and without oral contrast is essential for optimizing imaging protocols.
Purpose of the Study:
- To compare the test characteristics of abdominal CT with and without oral contrast for identifying intra-abdominal injuries in children.
- To determine if oral contrast significantly impacts the sensitivity and specificity of abdominal CT in pediatric blunt torso trauma.
Main Methods:
- A planned subanalysis of a prospective, multicenter study involving children (<18 years) with blunt torso trauma.
- Children who underwent abdominal CT with intravenous contrast were included.
- Oral contrast use was determined by institutional guidelines; clinical follow-up identified intra-abdominal injuries.
Main Results:
- Of 4,987 CT scans analyzed, 1,010 used oral contrast and 3,977 did not.
- Sensitivity for detecting intra-abdominal injuries was 99.2% with oral contrast vs. 97.7% without.
- Specificity was higher with oral contrast (84.7%) compared to without (80.8%).
Conclusions:
- Oral contrast is utilized in a significant number of pediatric abdominal CTs for blunt torso trauma.
- Test characteristics for detecting intra-abdominal injury are largely similar between CT with and without oral contrast.
- A slightly improved specificity was observed with oral contrast, but overall diagnostic performance was comparable.
Study Objective:
We compare test characteristics of abdominal computed tomography (CT) with and without oral contrast for identifying intra-abdominal injuries.
Methods:
This was a planned subanalysis of a prospective, multicenter study of children (<18 years) with blunt torso trauma. Children imaged in the emergency department with abdominal CT using intravenous contrast were eligible. Oral contrast use was based on the participating centers' guidelines and discretions. Clinical courses were followed to identify patients with intra-abdominal injuries. Abdominal CTs were considered positive for intra-abdominal injury if a specific intra-abdominal injury was identified and considered abnormal if any findings suggestive of intra-abdominal injury were identified on the CT.
Results:
A total of 12,044 patients were enrolled, with 5,276 undergoing abdominal CT with intravenous contrast. Of the 4,987 CTs (95%) with documented use or nonuse of oral contrast, 1,010 (20%) were with and 3,977 (80%) were without oral contrast; 686 patients (14%) had intra-abdominal injuries, including 127 CTs (19%) with and 559 (81%) without oral contrast. The sensitivity in the detection of any intra-abdominal injury in the oral contrast versus no oral contrast groups was sensitivitycontrast 99.2% (95% confidence interval [CI] 95.7% to 100.0%) versus sensitivityno contrast 97.7% (95% CI 96.1% to 98.8%), difference 1.5% (95% CI -0.4% to 3.5%). The specificity of the oral contrast versus no oral contrast groups was specificitycontrast 84.7% (95% CI 82.2% to 87.0%) versus specificityno contrast 80.8% (95% CI 79.4% to 82.1%), difference 4.0% (95% CI 1.3% to 6.7%).
Conclusion:
Oral contrast is still used in a substantial portion of children undergoing abdominal CT after blunt torso trauma. With the exception of a slightly better specificity, test characteristics for detecting intra-abdominal injury were similar between CT with and without oral contrast.
More Related Videos
06:02Anatomical Reconstructions of the Human Cardiac Venous System using Contrast-computed Tomography of Perfusion-fixed Specimens
Published on: April 18, 2013
08:41Novel In Vivo Micro-Computed Tomography Imaging Techniques for Assessing the Progression of Non-Alcoholic Fatty Liver Disease
Published on: March 24, 2023
Related Concept Videos
01:27Imaging Studies III: Computed Tomography
01:10Computed Tomography
The technique was invented in the 1970s and is based on the principle that as X-rays pass through the body, they are absorbed or reflected at different levels. In the technique, a patient lies on a motorized platform while a computerized axial tomography (CAT) scanner rotates...
01:30Radiological Investigation I: X-ray and CT
01:28Imaging Studies for Cardiovascular System V: CT
01:14Imaging Studies I: CT and MRI
Description of the Procedures
Computed Tomography (CT) scan:
Computed Tomography (CT) scans use X-ray technology to generate detailed images of bones, organs, and tissues. During the scan, the patient lies on a moving table...
01:24X-ray Imaging