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Real-time, contrast-enhanced sonography: a new tool for detecting active bleeding.
Orlando Catalano1, Fabio Sandomenico, Mauro Mattace Raso
1Department of Radiology, S. Maria delle Grazie Hospital, Pozzuoli, Italy. orlandcat@tin.it
The Journal of Trauma
|December 24, 2005
Summary
Contrast-enhanced ultrasound (CEUS) can detect active bleeding, a critical sign of hemorrhage. This pilot study demonstrates CEUS
Area of Science:
- Radiology
- Medical Imaging
- Ultrasound Technology
Background:
- Active contrast medium extravasation is a recognized sign of hemorrhage on angiography and CT.
- Sonography (US) is a primary imaging modality for abdominal emergencies.
- Advancements in low-mechanical-index, contrast-specific ultrasound systems enable detection of contrast leakage.
Purpose of the Study:
- To report pilot experience evaluating active bleeding using contrast-enhanced ultrasound (CEUS).
- To assess the utility of CEUS in identifying both traumatic and nontraumatic hemorrhage.
Main Methods:
- 153 consecutive emergent contrast-enhanced US studies were performed over 2 years.
- Contrast-specific mode (Contrast Tuned Imaging) and SonoVue contrast medium were utilized.
- A 2.4–4.8 mL contrast bolus was injected with 1–6 minutes of continuous US acquisition.
Main Results:
- Contrast extravasation was identified in 20 cases (13%).
- Detected extravasation included spleen/liver/kidney injuries, ruptured abdominal aortic aneurysms, splenic angiosarcoma rupture, and postsurgical bleeding.
- Active extravasation presented as hyperechoic pools or jets.
Conclusions:
- Ultrasound can detect contrast medium extravasation, indicating active hemorrhage.
- This finding signifies the need for prompt surgical or interventional treatment.
- This retrospective study highlights the potential of CEUS in managing active bleeding.