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

Area of Science:

• Pediatric radiology
• Emergency medicine
• Diagnostic imaging

Background:

• Blunt abdominal trauma (BAT) is a major cause of death in children, frequently leading to liver and spleen injuries.
• Contrast-enhanced computed tomography (CT) is the standard for diagnosing these injuries but involves radiation risks for children.
• Contrast-enhanced ultrasound (CEUS) presents a potential alternative imaging method.

Purpose of the Study:

• To assess the diagnostic effectiveness of CEUS for identifying solid organ injuries in pediatric patients after BAT.
• To compare the diagnostic accuracy of CEUS with existing methods for pediatric blunt abdominal trauma.

Main Methods:

• A systematic review and meta-analysis of studies published up to October 1, 2023, was performed.
• Literature search included PubMed, Scopus, Web of Science, and Embase databases.
• Diagnostic accuracy metrics were pooled using a bivariate model, with subgroup analysis for organ-specific accuracy.

Main Results:

• The meta-analysis of four studies (364 pediatric patients) showed a pooled sensitivity of 88.5% and specificity of 98.5% for CEUS.
• The area under the curve was 96%, indicating high diagnostic performance.
• CEUS demonstrated higher sensitivity for splenic injuries than liver injuries and higher specificity for kidney assessments.

Conclusions:

• CEUS shows significant diagnostic potential for solid organ injuries resulting from pediatric blunt abdominal trauma.
• Further large-scale research is recommended due to the limited sample size and number of studies included.