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Related Experiment Video

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Spontaneous and Traumatic Splenic Rupture: Retrospective Clinical, B-Mode and CEUS Analysis in 62 Patients.

M Rosling1, C Trenker2, A Neesse3

  • 1Interdisziplinäre Ultraschallzentrum, Universitätsklinikum Gießen und Marburg, Philipps Universität Marburg.

Ultrasound International Open
|April 10, 2018
PubMed
Summary

Spontaneous splenic rupture (SSR) patients are older and have higher mortality than traumatic splenic rupture (TSR) patients. Contrast-enhanced ultrasound (CEUS) is superior to B-mode ultrasound for grading splenic ruptures.

Keywords:
CEUSrupturespleensplenic rupture

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Area of Science:

  • Radiology
  • Emergency Medicine
  • Surgical Pathology

Background:

  • B-mode ultrasound and contrast-enhanced ultrasound (CEUS) are established for diagnosing traumatic splenic ruptures (TSR).
  • CEUS patterns in spontaneous splenic ruptures (SSR) are not well-documented.
  • Clinical and imaging differences between TSR and SSR remain unclear.

Purpose of the Study:

  • To compare clinical characteristics and imaging findings of spontaneous splenic ruptures (SSR) and traumatic splenic ruptures (TSR).
  • To evaluate the diagnostic performance of B-mode ultrasound versus CEUS in grading splenic ruptures.

Main Methods:

  • Retrospective analysis of 33 SSRs and 29 TSRs diagnosed between 12/2003 and 2/2010.
  • All patients underwent B-mode and CEUS examinations.
  • Clinical data and outcomes were analyzed.

Main Results:

  • SSR patients were significantly older (62 vs. 44 years; p=0.01) and had higher 4-week mortality (36% vs. 0%; p=0.001) than TSR patients.
  • No significant differences in B-mode or CEUS grading between SSR and TSR.
  • CEUS demonstrated superior grading accuracy compared to B-mode ultrasound (p=0.01).

Conclusions:

  • Significant clinical differences exist between SSR and TSR, particularly in age, disease course, and mortality.
  • Sonographic grading of splenic ruptures is similar for both SSR and TSR.
  • CEUS is recommended for suspected splenic ruptures to identify high-risk patients requiring intervention.