Title : Comparative informativeness of ultrasonic method and multispiral computed tomography in the diagnosis of abdominal trauma
Abstract:
Abdominal trauma occurs in 35% of cases in the structure of all possible injuries of organs and systems. Damage to the abdominal cavity is characterized by the multiplicity and severity of injuries, and associated serious impairment of vital functions, therefore the mortality rate for this pathology remains consistently high (8-70%). The purpose of the study is to determine the comparative information content of radiation research methods (ultrasound, multislice computed tomography) in the diagnosis of various types of injuries in patients with abdominal trauma in the early stages. The prospective study included 59 patients hospitalized at the Sklifosovsky Scientific Research Institute of NP with abdominal trauma from 2022 to 2024. Injuries to internal organs were verified intraoperatively and/or based on MSCT data. All patients underwent ultrasound and MSCT in the first hours of hospitalization, on an emergency basis without prior preparation. During the study, the following indicators were assessed: the presence of free fluid in the abdominal cavity, its nature, changes in the amount over time, the state of the structure of parenchymal and hollow organs, retroperitoneal space, changes in dynamics, assessment of vascularization of hematomas, signs of ongoing bleeding.
Analysis of retrospective data made it possible to establish that the sensitivity of ultrasound in detecting free fluid was 90%, the sensitivity of the MSCT method was 83%, the sensitivity of ultrasound in detecting liver injury was 72%, the sensitivity of the MSCT method was 85%. The sensitivity of ultrasound in detecting spleen injury was 84%, the sensitivity of the MSCT method was 99%, the sensitivity of ultrasound in detecting kidney injury was 52%, the sensitivity of the MSCT method was 83%, the MSCT method showed higher sensitivity values in identifying retroperitoneal hematomas - 93%, sensitivity Ultrasound was 73%. According to the results of the study, the ultrasound method showed low information content in the diagnosis of intestinal and mesenteric trauma, its sensitivity was 26%, the sensitivity of the MSCT method was 65%. Thus, the ultrasound method has shown higher sensitivity in identifying and dynamically assessing hemoperitoneum, and is an important stage in the clinical diagnostic algorithm for examining patients with abdominal trauma and justifying active-wait-and-see treatment tactics. The diagnostic capabilities of MSCT make it possible to use it for the initial assessment of damage to parenchymal organs and retroperitoneal hematoma. Both methods showed low sensitivity in diagnosing intestinal and mesenteric injuries.
