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Contrast-enhanced ultrasound imaging of active bleeding associated with hepatic and splenic trauma

Ecografia con mezzo di contrasto nel sanguinamento attivo associato a trauma epatico e splenico

  • Abdominal Radiology / Radiologia Addominale
  • Published:
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Abstract

Purpose

The aim of this study was to evaluate contrast-enhanced ultrasound (CEUS) imaging of active bleeding from hepatic and splenic trauma.

Materials and methods

Three hundred and ninety-two patients with liver or/and spleen trauma (179 liver and 217 spleen injuries), who underwent CEUS examinations following contrast-enhanced computed tomography (CT), were enrolled in this retrospective study over a period of >4 years. CEUS detected contrast medium extravasation or pooling in 16% (63/396) of liver or spleen lesions in 61 patients, which was confirmed by contrast-enhanced CT. Special attention was paid to observing the presence, location, and characteristics of the extravasated or pooled contrast medium.

Results

The CEUS detection rate for active bleeding was not different from that of contrast-enhanced CT (p=0.333). Information from surgery, minimally invasive treatment and conservative treatment was used as reference standard, and the sensitivities of the two techniques were not different (p=0.122). Of 63 lesions in 61 patients, CEUS showed that 74.6% (47/63) (21 liver lesions and 26 spleen lesions) presented contrast medium extravasation or pooling, both in the organ and out the capsule, in 14.3% (9/63) and only outside the capsule in 11.1% (7/63). CEUS imaging of active bleeding from hepatic and splenic trauma presented various characteristics, and the sizes and shapes of the active bleeding due to contrast medium extravasation or pooling were variable.

Conclusions

CEUS can show the active bleeding associated with hepatic and splenic trauma with various imaging characteristics, thus making it possible to diagnose active bleeding using CEUS.

Riassunto

Obiettivo

Scopo di questo lavoro è stato valutare l’imaging con ecografia con mezzo di contrasto (CEUS) nel sanguinamento attivo nei traumi epatici e splenici.

Materiali e metodi

Trecentonovantadue pazienti con trauma epatico e/o splenico (179 traumi epatici e 217 splenici), sottoposti ad esame CEUS seguito da tomografia computerizzata (CT) con mezzo di contrasto, sono stati arruolati in questo studio retrospettivo per un periodo di più di 4 anni. La CEUS ha rilevato lo stravaso o l’accumulo di mdc nel 16% (63/396) delle lesioni epatiche o spleniche in 61 pazienti, confermato poi dalla TC con mezzo di contrasto. È stata prestata particolare attenzione nell’osservare la presenza, la localizzazione e il carattere dello stravaso o dell’accumulo del mezzo di contrasto.

Risultati

La capacità della CEUS di individuare un sanguinamento attivo non si è dimostrata differente da quella della TC con mezzo di contrasto (p=0.333). Le informazioni ottenute dalla chirurgia, sia dal trattamento minimamente invasivo sia da quello conservativo, presi come riferimento standard, e la sensibilità delle due tecniche non si sono dimostrate differenti (p=0.122). Nelle 63 lesioni in 61 pazienti, la CEUS ha mostrato che il 74,6% (47/63) delle lesioni (21 lesioni epatiche e 26 spleniche) ha presentato stravaso o accumulo di mdc, entrambi all’interno dell’organo o fuori dalla capsula nel 14,3% (9/63) e solo fuori dalla capsula nell’11,1% (7/63). L’imaging CEUS del sanguinamento attivo da traumi epatici e splenici presenta differenti caratteristiche, e le dimensioni e le forme del sanguinamento attivo dovuto allo stravaso o all’accumulo del mezzo di contrasto sono variabili.

Conclusioni

La CEUS può mostrare il sanguinamento attivo associato a trauma epatico e splenico con diverse caratteristiche di imaging, rendendo quindi possibile diagnosticare il sanguinamento attivo.

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Authors and Affiliations

  1. Department of Ultrasound, Chinese People’s Liberation Army General Hospital, 28 Fuxing Road, Beijing, 100853, China

    F. Lv, J. Tang, Y. Luo, Z. Li, X. Meng, Z. Zhu & T. Li

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  1. F. Lv
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  2. J. Tang
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  3. Y. Luo
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  4. Z. Li
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  5. X. Meng
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  6. Z. Zhu
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  7. T. Li
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Correspondence to J. Tang.

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Lv, F., Tang, J., Luo, Y. et al. Contrast-enhanced ultrasound imaging of active bleeding associated with hepatic and splenic trauma. Radiol med 116, 1076–1082 (2011). https://doi.org/10.1007/s11547-011-0680-y

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  • DOI: https://doi.org/10.1007/s11547-011-0680-y

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