[size=20px]A 9 year old boy is seen in the trauma bay after being involved in a motor vehicle crash. He was the restrained back seat passenger. He is hemodynamically stable with normal vital signs. He is subsequently noted to have gross blood in his urine with concern for possible renal injury. When compared to traditional imaging methods, contrast-enhanced ultrasound has which of the following benefits:

 

A Better definition of the injury

 

B Higher sensitivity for identifying hemorrhage

 

C Avoidance of ionizing radiation

 

D Better evaluation of the urinary collecting system

 

E Faster polytraumatic injury identification​[/size]

E

E

C e

E

C

correct answer

C Avoidance of ionizing radiation

 

​Contrast enhanced ultrasonography (CEUS) may be a useful adjunct in the management of blunt pediatric trauma. Newer ultrasound contrast agents are stabilized with a phospholipid membrane allowing for a longer working time and increased resolution of vascular lesions. The use of CEUS in the evaluation of blunt traumatic injury may decrease the need for ionizing radiation and sedation in the pediatric population. However, there are limitations to the modality. CT and MRI have a higher sensitivity for delineating the extent of injury and hemorrhage. In the polytrauma patient, CT remains the fastest method to collect information. CEUS also requires experience with a radiologist and technician trained in its use. Proponents also support its use in follow-up of traumatic hepatic, splenic or renal injuries as a safer low cost alternative than repeat CT scans with better visualization than non contrast ultrasound.