Pediatric adrenal trauma: evaluation and follow-up with contrast-enhanced ultrasound (CEUS)

Area of Science:

• Pediatric radiology
• Diagnostic imaging
• Trauma imaging

Background:

• Adrenal trauma is uncommon in children, often part of multi-organ injuries and presenting as hematomas.
• Contrast-enhanced computed tomography (CECT) is standard for evaluating blunt abdominal trauma but involves radiation exposure.
• Minimizing radiation in pediatric imaging necessitates exploring alternative strategies.

Observation:

• Three pediatric cases of post-traumatic adrenal hematomas are presented.
• Initial diagnosis was made via CECT.
• Subsequent follow-up and evaluation were performed using contrast-enhanced ultrasound (CEUS).

Findings:

• CEUS successfully followed adrenal hematomas in pediatric patients.
• The technique demonstrated improved tissue contrast and spatial resolution compared to conventional ultrasound.
• CEUS effectively differentiated viable from necrotic tissue, crucial for injury assessment.

Implications:

• CEUS may be a valuable tool for the follow-up of pediatric adrenal injuries.
• It offers an alternative to repeated CECT, avoiding risks associated with ionizing radiation and iodine contrast agents.
• CEUS enhances diagnostic capabilities in pediatric trauma imaging.