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Sonography as the primary screening technique for blunt abdominal trauma: experience with 899 patients

K L McKenney, D B Nuñez, M G McKenney, J Asher, K Zelnick, D Shipshak
AJR. American Journal of Roentgenology 1998, 170 (4): 979-85

OBJECTIVE: The purpose of this study was to determine the accuracy of sonography when used routinely as the primary screening technique for blunt abdominal trauma.

SUBJECTS AND METHODS: From December 1994 through December 1995, we used sonography as the primary screening technique for the initial assessment of blunt abdominal trauma. Sonography was performed by dedicated technologists and overseen and interpreted by radiology residents or attending physicians. A positive study was defined as evidence of free fluid or parenchymal injury. Sonographic findings were correlated with CT, surgery, or clinical follow-up.

RESULTS: Of the 899 sonograms obtained for blunt abdominal trauma, the findings of 783 were negative, 101 were positive, and 15 were indeterminate. Of the 783 sonograms with negative findings, 768 (98%) were confirmed by CT, surgery, or clinical follow-up. Similarly, of the 101 sonograms with positive findings, 95 (94%) were confirmed. Interpretations resulted in 15 false-negative and five false-positive examinations. For all sonograms, we calculated a sensitivity of 86%, a specificity of 99%, and an accuracy of 98%.

CONCLUSION: Sonography can be used effectively as the primary screening technique for blunt abdominal trauma.

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