Splenic injury diagnosed with CT: US follow-up and healing rate in children and adolescents

PURPOSE: To determine if pediatric splenic injury healing observed during u ltrasonography (US) is related to the computed tomographic (CT) grade of in jury severity, to review any delayed complications, and to formulate a grad e-specific timetable for follow-up imaging. MATERIALS AND METHODS: Sixty-eight children and adolescents with CT-documen ted blunt splenic injury underwent US at approximate 6-week intervals to do cument injury healing (normal parenchyma or linear echogenic "scar"). Medic al records of those not followed up to complete healing were reviewed. RESULTS: Forty-eight patients were followed up to complete injury healing: 14 of injury grade 1 (mean, 7 weeks; range, 4-12 weeks), 24 of injury grade 2 (mean, 9.5 weeks; range 6-17 weeks), and 10 of injury grade 3 (mean, 16 weeks; range, 6-29 weeks). The difference in mean time to healing among all grades was significant (P < .02). Only two cysts were found; one decreased in size over time. No complications occurred in the 68 study patients. CONCLUSION: The time course to US-documented healing of blunt pediatric spl enic injury is related to injury severity. This information can be used to tailor follow-up imaging and provide cost savings.