Emergency Radiology

, Volume 11, Issue 1, pp 15–21 | Cite as

Real-time, contrast-specific sonography imaging of acute splenic disorders: a pictorial review

  • Orlando Catalano
  • Bianca Cusati
  • Antonio Nunziata
  • Alfredo Siani
Pictorial Essay


Real-time, contrast-specific ultrasonography (US) uses low-mechanical-index, harmonic software to stimulate echo emission from resounding second-generation contrast medium microbubbles. At our institution, contrast-enhanced US is increasingly being used in the evaluation of acute abnormalities of the spleen, mainly to overcome some limitations of conventional (basic) US. This pictorial essay illustrates the appearance of several acute splenic lesions, both traumatic and nontraumatic, on contrast-specific US.


Spleen Acute disorders Trauma Infarct Contrast-enhanced ultrasonography 


  1. 1.
    Bauer A, Solbiati L, Wessman N (2002) Ultrasound imaging with SonoVue: low mechanical index real-time imaging. Acad Radiol 9(Suppl 1):282–284CrossRefGoogle Scholar
  2. 2.
    Lencioni R, Cioni D, Bartolozzi C (2002) Tissue harmonic and contrast-specific imaging: back to gray scale in ultrasound. Eur Radiol 12:151–165CrossRefPubMedGoogle Scholar
  3. 3.
    Catalano O, Lobianco R, Sandomenico F, Siani A (2003) Splenic trauma: evaluation with contrast-specific sonography and a second-generation contrast medium: preliminary experience. J Ultrasound Med 22:467–477PubMedGoogle Scholar
  4. 4.
    Catalano O, Lobianco R, Sandomenico F, D’Elia G, Siani A (2003) Real-time, contrast-enhanced sonography of the spleen: examination technique and preliminary clinical experience. Radiol Med 106:338–356Google Scholar
  5. 5.
    Schneider M (1999) SonoVue, a new ultrasound contrast agent. Eur Radiol 9(Suppl 3): 347–348CrossRefPubMedGoogle Scholar
  6. 6.
    Morel DR, Schwieger I, Hohn L, Terrettaz J, Llull JB, Cornioley YA, Schneider M (2000) Human pharmacokinetics and safety evaluation of SonoVue, a new contrast agent for ultrasound imaging. Invest Radiol 35:80–85CrossRefPubMedGoogle Scholar
  7. 7.
    Bode PJ, Edwards MJ, Kruit MC, van Vugt AB (1999) Sonography in a clinical algorithm for early evaluation of 1671 patients with blunt abdominal trauma. AJR Am J Roentgenol 172:905–911PubMedGoogle Scholar
  8. 8.
    Dolich MO, McKenney MG, Varela JE, Compton RP, McKenney KL, Cohn SM (2001) 2,576 ultrasounds for blunt abdominal trauma. J Trauma 50:108–112PubMedGoogle Scholar
  9. 9.
    Brown MA, Casola G, Sirlin CB, Patel NY, Hoyt DB (2001) Blunt abdominal trauma: screening US in 2,693 patients. Radiology 218:352–358PubMedGoogle Scholar
  10. 10.
    Richards JR, McGahan JP, Jones CD, Zhan S, Gerscovich EO (2001) Ultrasound detection of blunt splenic injury. Injury 32:95–103CrossRefPubMedGoogle Scholar
  11. 11.
    Shanmuganathan K, Mirvis SE, Sherbourne CD, Chiu WC, Rodriguez A (1999) Hemoperitoneum as the sole indicator of abdominal visceral injuries: a potential limitation for screening abdominal US for trauma. Radiology 212:423–430PubMedGoogle Scholar
  12. 12.
    Chiu WC, Cushing BM, Rodriguez A, Ho SM, Mirvis SE, Shanmuganathan K et al (1997) Abdominal injuries without hemoperitoneum: a potential limitation of focused abdominal sonography for trauma (FAST). J Trauma 42:617–623PubMedGoogle Scholar
  13. 13.
    Poletti P-A, Kinkel K, Vermeulen B, Irmay F, Unger P-F, Terrier F (2003) Blunt abdominal trauma: should US be used to detect both free fluid and organ injuries? Radiology 227:95–103PubMedGoogle Scholar
  14. 14.
    Beckman M (2003) Ultrasound with contrast enhancement as a means to assess trauma patients—an initial experience. Digital Imagery (ASER 14th Annual Scientific Meeting book):84–85Google Scholar
  15. 15.
    Poletti P-A (2003) Contrast-enhanced ultrasound in blunt abdominal trauma: the Geneva experience. Digital Imagery (ASER 14th Annual Scientific Meeting book):85–86Google Scholar
  16. 16.
    Martegani A, Cosgrove DO, Del Favero C, Aiani L, Harvey CJ (2002) Contrast enhanced abdominal ultrasound in trauma using Sonovue. Radiology 225(p): 358 (Radiological Society of North America, oral presentation)Google Scholar
  17. 17.
    Poletti P-A, Platon A, Becker C, Terrier F (2003) The value of contrast-enhanced sonography to improve detection of liver and spleen traumatic injuries: a comparison with contrast enhanced CT. Oral presentation, Radiological Society of North America, Radiology (p):45Google Scholar
  18. 18.
    Brown JM, Quedens-Case C, Alderman JL, Greener Y, Taylor KJ (1997) Contrast enhanced sonography of visceral perfusion defects in dogs. J Ultrasound Med 16:493–499PubMedGoogle Scholar
  19. 19.
    Goldberg BB, Merton DA, Liu J-B, Forsberg F (1998) Evaluation of bleeding sites with a tissue-specific sonographic contrast agent: preliminary experiences in an animal model. J Ultrasound Med 17:609–616PubMedGoogle Scholar
  20. 20.
    Liu J-B, Merton DA, Goldberg BB, Rawool NM, Shi WT, Forsberg F (2000) Contrast-enhanced two- and three-dimensional sonography for evaluation of intra-abdominal hemorrhage. J Ultrasound Med 21:161–169CrossRefGoogle Scholar
  21. 21.
    Schurr MJ, Fabian TC, Gavant M, Croce MA, Kudsk KA, Minard G, et al (1995) Management of blunt splenic trauma: computed tomography contrast blush predicts failure of nonoperative management. J Trauma 39:507–513PubMedGoogle Scholar
  22. 22.
    Gavant ML, Schurr M, Flick PA, Croce MA, Fabian TC, Gold RE (1997) Predicting clinical outcome of nonsurgical management of blunt splenic injury: using CT to reveal abnormalities of splenic vasculature. AJR Am J Roentgenol 168:207–212PubMedGoogle Scholar
  23. 23.
    Federle MP, Courcoulas AP, Powell M, Ferris J, Peitzman AB (1998) Blunt splenic injury in adults: clinical and CT criteria for management, with emphasis on active extravasation. Radiology 206:137–142PubMedGoogle Scholar
  24. 24.
    Shanmuganathan K, Mirvis SE, Boyd-Kranis R, Takada T, Scalea TM (2000) Nonsurgical management of blunt splenic injury: use of CT criteria to select patients for splenic arteriography and potential endovascular therapy. Radiology 217:75–82PubMedGoogle Scholar
  25. 25.
    Omert LA, Salyer D, Dunham CM, Porter J, Silva A, Protetch J (2001) Implications of the “contrast blush” findings on computed tomographic scan of the spleen in trauma. J Trauma 51:272–27PubMedGoogle Scholar
  26. 26.
    Yao DC, Jeffrey RB, Mirvis SE, Weejes A, Federle MP, Kim C, et al (2002) Using contrast-enhanced helical CT to visualize arterial extravasation after blunt abdominal trauma. AJR Am J Roentgenol 178:17–20PubMedGoogle Scholar
  27. 27.
    Willmann JK, Roos JE, Platz A, Pfammatter T, Hilfiker PR, Marincek B, et al (2002) Multidetector CT: detection of active hemorrhage in patients with blunt abdominal trauma. AJR Am J Roentgenol 179:437–444PubMedGoogle Scholar

Copyright information

© Am Soc Emergency Radiol 2004

Authors and Affiliations

  • Orlando Catalano
    • 2
    • 3
  • Bianca Cusati
    • 2
  • Antonio Nunziata
    • 1
  • Alfredo Siani
    • 2
  1. 1.Department of Diagnostic ImagingPSI Napoli ESTNaplesItaly
  2. 2.Department of RadiologyS. Maria delle Grazie HospitalPozzuoliItaly
  3. 3.NaplesItaly

Personalised recommendations