Cargando…

Detection of post-traumatic abdominal pseudoaneurysms by CEUS and CT: A prospective comparative global study (the PseAn study)—study protocol

The success of non-operative management in trauma increased with the availability of new-generation CT scan machines, endoscopy, and angiography, becoming the standard of care in hemodynamically stable trauma patients with abdominal solid organ injuries, with a success rate of 78% to 98%. Post-traum...

Descripción completa

Detalles Bibliográficos
Autores principales: Virdis, Francesco, Cioffi, Stefano Piero Bernardo, Abu-Zidan, Fikri, Reitano, Elisa, Podda, Mauro, Altomare, Michele, Spota, Andrea, Bini, Roberto, Kumar, Jayant, Chiara, Osvaldo, Cimbanassi, Stefania
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9986536/
https://www.ncbi.nlm.nih.gov/pubmed/36891548
http://dx.doi.org/10.3389/fsurg.2023.1124087
_version_ 1784901190777044992
author Virdis, Francesco
Cioffi, Stefano Piero Bernardo
Abu-Zidan, Fikri
Reitano, Elisa
Podda, Mauro
Altomare, Michele
Spota, Andrea
Bini, Roberto
Kumar, Jayant
Chiara, Osvaldo
Cimbanassi, Stefania
author_facet Virdis, Francesco
Cioffi, Stefano Piero Bernardo
Abu-Zidan, Fikri
Reitano, Elisa
Podda, Mauro
Altomare, Michele
Spota, Andrea
Bini, Roberto
Kumar, Jayant
Chiara, Osvaldo
Cimbanassi, Stefania
author_sort Virdis, Francesco
collection PubMed
description The success of non-operative management in trauma increased with the availability of new-generation CT scan machines, endoscopy, and angiography, becoming the standard of care in hemodynamically stable trauma patients with abdominal solid organ injuries, with a success rate of 78% to 98%. Post-traumatic pseudoaneurysms (PAs) can develop at any region of an injured artery and they may cause delayed bleeding in splenic or hepatic trauma, with an incidence in patients treated with NOM of 2%–27% and 1.2%–6.1% respectively. Diagnosis is made by angiography, contrast-enhanced computer tomography (CT), or Doppler Ultrasound (US) while the use of contrast-enhanced ultrasound (CEUS), has increased in recent years although few data are available about CEUS feasibility in the follow-up setting. The PseaAn study has been designed to assess the role of CEUS in the follow-up of abdominal trauma by defining its sensitivity, specificity and predictive values compared with abdominal CT scan. The PseAn study is a multi-centric international diagnostic cross-sectional study initiated by the Level I Trauma Center of the Niguarda Ca’ Granda Hospital in Milan, Italy. To study the role of CEUS in detecting post-traumatic splenic, hepatic, and renal PAs compared with the gold standard of CT with intravenous contrast at different follow-up time points, and whether it can replace CT scan in the follow-up of solid organ injuries, patients with OIS III and above will undergo a follow-up with both a CEUS and CT scan to detect post-traumatic parenchymal pseudoaneurysm within two to five days from injury. The use of CEUS in the follow-up of abdominal trauma follow-up (particularly blunt trauma) has increased, to minimise the use of ionizing radiation and contrast media and encouraging results have been published during the last decade showing that CEUS is an accurate technique for evaluating traumatic lesions of solid abdominal organs. Conclusions We think that CEUS, which is underused worldwide, is a useful and safe tool that may replace CT scan in follow-up with the major advantage of reduced radiation. Our current study may give stronger evidence to support this view.
format Online
Article
Text
id pubmed-9986536
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-99865362023-03-07 Detection of post-traumatic abdominal pseudoaneurysms by CEUS and CT: A prospective comparative global study (the PseAn study)—study protocol Virdis, Francesco Cioffi, Stefano Piero Bernardo Abu-Zidan, Fikri Reitano, Elisa Podda, Mauro Altomare, Michele Spota, Andrea Bini, Roberto Kumar, Jayant Chiara, Osvaldo Cimbanassi, Stefania Front Surg Surgery The success of non-operative management in trauma increased with the availability of new-generation CT scan machines, endoscopy, and angiography, becoming the standard of care in hemodynamically stable trauma patients with abdominal solid organ injuries, with a success rate of 78% to 98%. Post-traumatic pseudoaneurysms (PAs) can develop at any region of an injured artery and they may cause delayed bleeding in splenic or hepatic trauma, with an incidence in patients treated with NOM of 2%–27% and 1.2%–6.1% respectively. Diagnosis is made by angiography, contrast-enhanced computer tomography (CT), or Doppler Ultrasound (US) while the use of contrast-enhanced ultrasound (CEUS), has increased in recent years although few data are available about CEUS feasibility in the follow-up setting. The PseaAn study has been designed to assess the role of CEUS in the follow-up of abdominal trauma by defining its sensitivity, specificity and predictive values compared with abdominal CT scan. The PseAn study is a multi-centric international diagnostic cross-sectional study initiated by the Level I Trauma Center of the Niguarda Ca’ Granda Hospital in Milan, Italy. To study the role of CEUS in detecting post-traumatic splenic, hepatic, and renal PAs compared with the gold standard of CT with intravenous contrast at different follow-up time points, and whether it can replace CT scan in the follow-up of solid organ injuries, patients with OIS III and above will undergo a follow-up with both a CEUS and CT scan to detect post-traumatic parenchymal pseudoaneurysm within two to five days from injury. The use of CEUS in the follow-up of abdominal trauma follow-up (particularly blunt trauma) has increased, to minimise the use of ionizing radiation and contrast media and encouraging results have been published during the last decade showing that CEUS is an accurate technique for evaluating traumatic lesions of solid abdominal organs. Conclusions We think that CEUS, which is underused worldwide, is a useful and safe tool that may replace CT scan in follow-up with the major advantage of reduced radiation. Our current study may give stronger evidence to support this view. Frontiers Media S.A. 2023-02-20 /pmc/articles/PMC9986536/ /pubmed/36891548 http://dx.doi.org/10.3389/fsurg.2023.1124087 Text en © 2023 Virdis, Cioffi, Abu-Zidan, Reitano, Podda, Altomare, Spota, Bini, Kumar, Chiara and Cimbanassi. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Surgery
Virdis, Francesco
Cioffi, Stefano Piero Bernardo
Abu-Zidan, Fikri
Reitano, Elisa
Podda, Mauro
Altomare, Michele
Spota, Andrea
Bini, Roberto
Kumar, Jayant
Chiara, Osvaldo
Cimbanassi, Stefania
Detection of post-traumatic abdominal pseudoaneurysms by CEUS and CT: A prospective comparative global study (the PseAn study)—study protocol
title Detection of post-traumatic abdominal pseudoaneurysms by CEUS and CT: A prospective comparative global study (the PseAn study)—study protocol
title_full Detection of post-traumatic abdominal pseudoaneurysms by CEUS and CT: A prospective comparative global study (the PseAn study)—study protocol
title_fullStr Detection of post-traumatic abdominal pseudoaneurysms by CEUS and CT: A prospective comparative global study (the PseAn study)—study protocol
title_full_unstemmed Detection of post-traumatic abdominal pseudoaneurysms by CEUS and CT: A prospective comparative global study (the PseAn study)—study protocol
title_short Detection of post-traumatic abdominal pseudoaneurysms by CEUS and CT: A prospective comparative global study (the PseAn study)—study protocol
title_sort detection of post-traumatic abdominal pseudoaneurysms by ceus and ct: a prospective comparative global study (the psean study)—study protocol
topic Surgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9986536/
https://www.ncbi.nlm.nih.gov/pubmed/36891548
http://dx.doi.org/10.3389/fsurg.2023.1124087
work_keys_str_mv AT virdisfrancesco detectionofposttraumaticabdominalpseudoaneurysmsbyceusandctaprospectivecomparativeglobalstudythepseanstudystudyprotocol
AT cioffistefanopierobernardo detectionofposttraumaticabdominalpseudoaneurysmsbyceusandctaprospectivecomparativeglobalstudythepseanstudystudyprotocol
AT abuzidanfikri detectionofposttraumaticabdominalpseudoaneurysmsbyceusandctaprospectivecomparativeglobalstudythepseanstudystudyprotocol
AT reitanoelisa detectionofposttraumaticabdominalpseudoaneurysmsbyceusandctaprospectivecomparativeglobalstudythepseanstudystudyprotocol
AT poddamauro detectionofposttraumaticabdominalpseudoaneurysmsbyceusandctaprospectivecomparativeglobalstudythepseanstudystudyprotocol
AT altomaremichele detectionofposttraumaticabdominalpseudoaneurysmsbyceusandctaprospectivecomparativeglobalstudythepseanstudystudyprotocol
AT spotaandrea detectionofposttraumaticabdominalpseudoaneurysmsbyceusandctaprospectivecomparativeglobalstudythepseanstudystudyprotocol
AT biniroberto detectionofposttraumaticabdominalpseudoaneurysmsbyceusandctaprospectivecomparativeglobalstudythepseanstudystudyprotocol
AT kumarjayant detectionofposttraumaticabdominalpseudoaneurysmsbyceusandctaprospectivecomparativeglobalstudythepseanstudystudyprotocol
AT chiaraosvaldo detectionofposttraumaticabdominalpseudoaneurysmsbyceusandctaprospectivecomparativeglobalstudythepseanstudystudyprotocol
AT cimbanassistefania detectionofposttraumaticabdominalpseudoaneurysmsbyceusandctaprospectivecomparativeglobalstudythepseanstudystudyprotocol