ORIGINAL ARTICLE   

Il Giornale Italiano di Radiologia Medica 2019 Maggio-Giugno;6(3):191-6

DOI: 10.23736/S2283-8376.19.00193-1

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English, Italian

Foreign bodies retained in soft tissues non-detectable by traditional radiographic examination. Utility of ultrasound in their identification and removal

Chiara M. MORGANO ✉, Marco CALVI, Chiara TAGLIAFERRI, Leonardo CALLEGARI, Eugenio A. GENOVESE

University of Insubria, Ospedale Di Circolo, ASST-Settelaghi, Varese, Italy

BACKGROUND: Evaluate the diagnostic accuracy of ultrasound in identifying foreign bodies (FB) non-detectable by traditional radiographic examination, and to demonstrate the advantages and minimal invasiveness of the ultrasound guided removal technique.
METHODS: From November 2016 to March 2018, 25 patients with average age of 49 years and clinical suspicion of soft tissue foreign bodies, arrived at our hospital, each one with apparent negative radiographic examination. All patients, therefore, underwent ultrasound diagnostic evaluation using a Toshiba Aplio 500 Ultrasound System equipped with high frequency linear probes (12 and 17 MHz). 28 rx-transparent foreign bodies were identified. Twenty-three splinters of wood and 5 fragments of glass found on the ultrasound examination, were removed under ultrasound guidance after skin incision and scalpel subcutaneous surgery.
RESULTS: In all patients it was possible to successfully remove foreign bodies under ultrasound guidance. No peri- or postprocedural complications were recorded. We performed statistical analysis for ultrasound detection rate and diagnosis of foreign bodies considered unrecognisable by traditional radiographic examination and obtained the following results: sensitivity (100%), specificity (96.67), VPP (96.55) and VPN (100%).
CONCLUSIONS: Ultrasonography has shown greater accuracy than traditional radiography in the diagnosis of foreign bodies located in soft tissue and represents the first-choice survey for the diagnosis and removal of routine radiographic non-detectable FB.

KEY WORDS: Ultrasonography; Foreign bodies; Soft tissue injuries