TCHCCT-Zhong-Xing-Emergency-Department Ultrasound With IV Contrast in Acute Flank Pain

Study Overview
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Brief Summary
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To evaluate the efficiency of ultrasound with IV contrast and compare this with the Computed Tomography in acute flank pain patient at Emergency Department.

Detailed Description
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Acute flank pain is a common chief complaint in emergency departments (ED), but it is a challenge for physicians in ED to accurately diagnose. It can cause variable diseases and is in many cases lethal (e.g. aortic dissection, ruptured aortic aneurysm, renal artery dissection, ruptured tumor, etc). The computed tomography scan with IV contrast is an ideal tool to diagnose due to its high sensitivity and specificity and is a golden standard examination. However, currently point-of-care ultrasound is routinely used as first-line technique. As this procedure is non-invasive and has no radiative effect, it is considered more logical, especially for those critical patients who are not able to move and perform the CT scan. Furthermore, the iodine contrast of CT scan is known as renal toxicity and should be used with caution in patient with hyperthyroidism and allergy to the contrast. The radiation of CT scan would be harmful to the pregnant patient as well. IV contrast ultrasound is a novel technique nowadays and it is widely used in diagnosing breast, liver, renal and pancreatic tumors. The ultrasound contrast using air microbubbles could enhance the scanning quality and also has high sensitivity and specificity. In ED, ultrasound with contrast now could be applied to the abdominal trauma and pediatric injury. For those patients with poor renal function, thyroid disease and pregnant women who cannot undergo IV contrast CT, IV contrast ultrasound provides a faster and safer way to evaluate patients in ED. We compared CT and ultrasound with IV contrast to determine the difference in efficiency between both examinations.

Official Title
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A Novel Technique for the Assessment of Non-traumatic Pain Diagnosis in the Emergency Department.

Conditions
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Acute Flank Pain

Intervention / Treatment
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* Diagnostic Test: Ultrasound with IV contrast
* Diagnostic Test: CT with IV contrast
* Diagnostic Test: Ultrasound without IV contrast
* Diagnostic Test: CT without IV contrast


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Acute flank pain who visit ER Exclusion Criteria: Younger than 18 years old Known allergy to contrast

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Diagnostic
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Ultrasound with IV contrast<br>use ultrasound with IV contrast to perform in acute flank pain patient | Diagnostic Test: Ultrasound with IV contrast<br>* To compare the efficiency over the ultrasound scan within contrast<br>|
| Active Comparator: CT with IV contrast<br>to compare with ultrasound with IV contrast in acute flank pain patient | Diagnostic Test: CT with IV contrast<br>* CT with IV contrast<br>|
| Active Comparator: Ultrasound without IV contrast<br>baseline for the Ultrasound with IV contrast | Diagnostic Test: Ultrasound without IV contrast<br>* Ultrasound without IV contrast<br>|
| Active Comparator: CT without IV contrast<br>baseline for the CT with IV contrast | Diagnostic Test: CT without IV contrast<br>* CT without IV contrast<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The diagnostic rate of ultrasound with IV contrast in acute flank pain patient | Evaluate the sensitivity and specificity in ultrasound scan | The hospitalization of each participant, up to 28 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| To compare the efficiency over the ultrasound and CT scan within or without contrast | compared the sensitivity and specificity between CT and ultrasound scan | The hospitalization of each participant, up to 28 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Acute flank pain, Ultrasound, IV contrast