Ultraschall in der Medizin (Stuttgart, Germany : 1980) · 2026
Contrast-Enhanced Ultrasound Versus Contrast-Enhanced Computed Tomography in the Detection of Renal and Splenic Infarctions.
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Hoppe John Michael, Deniz Sinan, Czihal Michael, Lottspeich Christian
Аннотация
PURPOSE: Intra-abdominal organ infarctions require prompt imaging for diagnosis. Contrast-enhanced computed tomography (CECT) is considered the gold standard but involves radiation, iodinated contrast, and logistical challenges in critically ill patients. Contrast-enhanced ultrasound (CEUS) enables real-time assessment of microvascular perfusion without ionizing radiation. The aim of this study was to evaluate the diagnostic performance of CEUS compared to CECT for detecting intra-abdominal organ infarctions.
MATERIALS AND METHODS: This retrospective observational study included patients treated at a tertiary care center (2010-2024) who underwent both CEUS and CECT for suspected intra-abdominal organ infarction. With CECT as reference standard, diagnostic performance parameters and agreement (Cohen's kappa) were calculated.
RESULTS: 24 patients (median age 60 years; 12 female) were included. CECT confirmed organ infarction in 16/24 patients (66.7%). CEUS correctly identified 15 of these cases (Sensitivity 93.8%; 95% confidence interval [CI]: 71.7-98.9%). Specificity was 75.0% (95% CI: 40.9-92.9%), with two false-positive CEUS findings. Positive and negative predictive values were 88.2% (95% CI: 65.7-96.7%) and 85.7% (95% CI: 48.7-97.4%), respectively. Agreement of CECT and CEUS was substantial (Cohen's κ = 0.71). Wedge-shaped perfusion defects were identified in 93.8% of CT-confirmed infarctions on both modalities.
CONCLUSION: CEUS demonstrates high sensitivity and good agreement with CECT for the detection of intra-abdominal organ infarctions. CEUS represents a valuable imaging modality, particularly when CECT is contraindicated or not available. Prospective studies are warranted to further define its role in clinical practice.
MATERIALS AND METHODS: This retrospective observational study included patients treated at a tertiary care center (2010-2024) who underwent both CEUS and CECT for suspected intra-abdominal organ infarction. With CECT as reference standard, diagnostic performance parameters and agreement (Cohen's kappa) were calculated.
RESULTS: 24 patients (median age 60 years; 12 female) were included. CECT confirmed organ infarction in 16/24 patients (66.7%). CEUS correctly identified 15 of these cases (Sensitivity 93.8%; 95% confidence interval [CI]: 71.7-98.9%). Specificity was 75.0% (95% CI: 40.9-92.9%), with two false-positive CEUS findings. Positive and negative predictive values were 88.2% (95% CI: 65.7-96.7%) and 85.7% (95% CI: 48.7-97.4%), respectively. Agreement of CECT and CEUS was substantial (Cohen's κ = 0.71). Wedge-shaped perfusion defects were identified in 93.8% of CT-confirmed infarctions on both modalities.
CONCLUSION: CEUS demonstrates high sensitivity and good agreement with CECT for the detection of intra-abdominal organ infarctions. CEUS represents a valuable imaging modality, particularly when CECT is contraindicated or not available. Prospective studies are warranted to further define its role in clinical practice.