Contrast-Enhanced B-Flow Ultrasound: A Novel Approach to Liver Trauma Imaging

Area of Science:

• Medical Imaging
• Ultrasound Technology
• Trauma Surgery

Background:

• Contrast-enhanced ultrasound (CEUS) is valuable for detecting perfusion disruptions in solid organ trauma.
• B-Flow ultrasound excels at high-fidelity imaging of larger vessels.
• Accurate delineation of hepatic vessel injury is crucial for patient management and guiding therapies.

Purpose of the Study:

• To evaluate the accuracy of contrast-enhanced B-Flow (CEB-Flow) in delineating hepatic vessel injuries.
• To assess CEB-Flow as an adjunct tool to CEUS for traumatic liver injury.
• To determine if CEB-Flow improves the identification of injured liver parenchyma and lacerated vessels.

Main Methods:

• A swine model of traumatic liver injury was utilized.
• Sonography was performed using a Logiq E10 scanner with a C1-6 probe.
• B-Mode ultrasound, CEUS, and CEB-Flow were applied during contrast agent infusion (Definity).
• Three blinded interpreters assessed images, comparing identification rates with pathology confirmation.

Main Results:

• CEUS identified liver injury with 88.3%-100% accuracy; CEB-Flow showed 50%-66.7% accuracy.
• Parenchymal injury identification rates were not significantly different between CEUS (91.7%) and CEB-Flow (66.7%).
• CEB-Flow significantly improved lacerated vessel identification (91.7%) compared to CEUS (41.7%, p=0.041).

Conclusions:

• The combination of CEUS and CEB-Flow accurately identifies and localizes traumatic hepatic injury.
• CEB-Flow demonstrates superior characterization of hepatic vessel injuries.
• CEB-Flow has the potential to enhance bedside management of liver trauma.