Evaluation of bleeding sites with a tissue-specific sonographic contrast agent: preliminary experiences in an animal...

The purpose of this study was to determine the feasibility and usefulness of using an ultrasonographic contrast agent to enhance the sonographic detection of bleeding sites in a canine model. SH U 563, an ultrasound contrast agent that elicits acoustic emission (i.e., random transient Doppler shifts produced by contrast particle rupture) even when stationary, was used. Acoustic emission is identified as a mosaic pattern on color Doppler imaging. A total of 13 active bleeding sites were created within intraabdominal organs (kidney and spleen, n = 3), the urinary tract (n = 3), and the gastrointestinal tract (n = 7) in three canine models. Gray scale and color Doppler imaging studies were performed prior to and after each of 13 individual intravenous contrast agent administrations. Imaging results were compared to gross pathologic findings. After contrast agent administration, pooling of contrast medium-containing blood in the regions adjacent to bleeding sites could be detected with color Doppler imaging as regions with the characteristic acoustic emission color display. After injection gray scale imaging failed to demonstrate the location or extent of hemorrhaging adequately. A linear relationship existed between the blood loss due to gastrointestinal tract bleeding and the amount of acoustic emission detected (r2 = 0.81). SH U 563 combined with color Doppler imaging improves the detection of bleeding sites in a variety of locations throughout the body.