DIAGNOSTIC ACCURACY OF ULTRASONOGRAPHY IN DETECTION OF LIVER INJURIES IN TRAUMA PATIENTS KEEPING CT AS GOLD STANDARD

Abstract

Objective:
The present study aimed to determine the diagnostic accuracy of ultrasonography in detecting liver injuries in patients with abdominal trauma, using computed tomography (CT) as the gold standard.

Methodology:
This cross-sectional diagnostic accuracy study was conducted in the radiology and emergency departments of Pakistan Institute of Medical Sciences, Islamabad. A total of 120 trauma patients with suspected abdominal injury who underwent both ultrasonography and CT scan were included using a non-probability consecutive sampling technique. Hemodynamically unstable patients, patients with a history of liver disease, and those who did not undergo CT scan were excluded. Ultrasonography examinations were performed by experienced radiologists using standard abdominal protocols to detect liver injuries such as lacerations, hematomas, or free fluid. CT scan findings were interpreted independently and considered the gold standard. Diagnostic parameters including sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall diagnostic accuracy were calculated using statistical software.

Results:
Among the 120 patients, the mean age was 34.6 ± 12.8 years, with males comprising 65% of the study population. Road traffic accidents were the most common mechanism of trauma (51.7%). CT scan confirmed liver injuries in 50 (41.7%) patients. Ultrasonography detected liver injury in 48 patients, with 45 true positives, 63 true negatives, 7 false positives, and 5 false negatives. The sensitivity and specificity of ultrasonography were both 90%, with a PPV of 86.5%, NPV of 92.6%, and an overall diagnostic accuracy of 90%.

Conclusion:
Ultrasonography is an effective, rapid, and non-invasive initial screening tool for detecting liver injuries in trauma patients; however, CT remains the most accurate modality for definitive diagnosis and detailed injury assessment.