Real-Time, Contrast-Enhanced Sonography: A New Tool for Detecting Active Bleeding

Catalano, Orlando; Sandomenico, Fabio; Raso, Mauro Mattace; Siani, Alfredo

doi:10.1097/01.ta.0000188129.91271.ab

Cited by 55 publications

(36 citation statements)

References 23 publications

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“…Catalano et al performed CEUS examinations in 83 traumatic emergencies, and their clinical study showed for the fi rst time how US can detect contrast medium extravasation, a signifi cant indicator of active haemorrhage. They concluded that their preliminary work showed that CEUS may be a new tool for detecting active bleeding [13]. However, whether CEUS can evaluate active bleeding from abdominal parenchymal organ trauma is still a matter of debate.…”

Section: Introductionmentioning

confidence: 96%

Contrast-enhanced ultrasound imaging of active bleeding associated with hepatic and splenic trauma

Tang

Luo

et al. 2011

Radiol med

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Section: Introductionmentioning

confidence: 96%

Contrast-enhanced ultrasound imaging of active bleeding associated with hepatic and splenic trauma

Tang

Luo

et al. 2011

Radiol med

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“…Because the ability to detect the blood flow on CDUS is dependent on the flow velocity, detecting bleeding with a low flow velocity is difficult. Contrast-enhanced ultrasound (CEUS) exhibits 100% sensitivity and 100% specificity for active bleeding and is useful for detecting less dramatic or non-arterial bleeding (13,14). However, no reports have investigated the rate of detection of microbubble flow signals along the needle tract following percutaneous liver biopsy.…”

Section: Introductionmentioning

confidence: 99%

Assessment of Track Microbubble Flow Signals on Contrast-enhanced Ultrasound with Perflubutane Following Percutaneous Liver Biopsy

et al. 2013

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Objective It is important to detect post-liver biopsy hemorrhage early and confirm hemostasis in the clinical setting. Contrast-enhanced ultrasound (CEUS) is a sensitive and highly specific tool for detecting active bleeding. The aim of this study was to investigate the rate of detection of track microbubble flow signals on CEUS with perflubutane following liver biopsy and to assess the disappearance of these signals.Methods Microbubble flow signals along the needle track on CEUS were examined in 100 patients who underwent percutaneous US-guided liver biopsies. The microbubble flow signals were examined repeatedly until their disappearance. The patients were followed up with clinical and laboratory data to detect clinically significant hemorrhaging. Results Microbubble flow signals on CEUS following percutaneous liver biopsy were seen in 33% of the patients. There were no significant differences in the platelet count, prothrombin time or length of the biopsy specimen between the patients with and those without microbubble flow signals on CEUS. The microbubble flow signals disappeared over time in all patients. There were no cases of clinically significant hemorrhaging in the present study. Conclusion Track microbubble flow signals on CEUS are frequently observed after biopsies. The disappearance of a microbubble flow signal is a useful index for confirming hemostasis of postbiopsy hemorrhaging.

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“…2a), and the other was contrast leakage appearing as fountain-like, hyperechoic jet (Fig. 2b) [8]. After treatment, CEUS demonstrated that active bleeding disappeared.…”

Section: Resultsmentioning

confidence: 96%

Effectiveness and safety of CEUS-guided haemostatic injection for blunt splenic trauma: an animal experiment

Tang

et al. 2010

Radiol med

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The aim of this study was to investigate whether complications occur after haemostatic agents are injected into blunt splenic injuries. After undergoing ultrasound (US), contrast-enhanced US (CEUS) and contrast-enhanced computed tomography (CECT) examinations, dogs with grade III-IV injury received the minimally invasive therapy. After treatment, CEUS was performed to observe changes in the regions treated. In the immediate group, dogs underwent laparotomy 30 min after treatment to observe the haemostatic effect. In the survival group, animals underwent CEUS and CECT examinations to observe the short-term healing outcome and complications at 3, 7, 14, and 21 days after the injection. After undergoing CEUS and CECT examinations, 12 dogs with grade III-IV injury received the minimally invasive therapy. Before injection, CEUS examinations showed anechoic and/or hypoechoic perfusion defects and active bleeding at the injury sites, and CECT showed traumatic lesions as low-density regions without enhancement. After treatment, CEUS demonstrated the disappearance of active bleeding, and hyperechoic spots emerged at the injury sites. Uneven density regions were displayed on CECT. Treated areas were covered by blood clots and glue membrane in the immediate-group animals. Three weeks later, CEUS showed a decrease of hyperechoic spots in the survival group, and the splenic parenchyma enhanced uniformly on CECT. Laparotomy showed that the greater omentum had moved upwards and partly covered the wound in four animals, and the injury sites had completely healed. Histopathological examination showed that fibrous connective tissue covered the splenic capsule and that the haemostatic glue had degraded. No complication occurred, such as delayed splenic haemorrhage, splenic abscesses, splenic pseudoaneurysms, intestinal obstruction or intestinal adhesions. CEUS-guided haemostatic injection is not only effective in stopping active bleeding immediately, but it is also safe in that no complications occurred during the 3 weeks of follow-up. This study indicates that CEUS-guided percutaneous injection may provide a safe, feasible and effective therapy for blunt splenic trauma.

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Real-Time, Contrast-Enhanced Sonography: A New Tool for Detecting Active Bleeding

Abstract: Our retrospective clinical study shows for the first time how US can detect contrast medium extravasation, a significant indicator of active hemorrhage and of need for prompt surgical or interventional treatment.

Cited by 55 publications

References 23 publications

Contrast-enhanced ultrasound imaging of active bleeding associated with hepatic and splenic trauma

Contrast-enhanced ultrasound imaging of active bleeding associated with hepatic and splenic trauma

Assessment of Track Microbubble Flow Signals on Contrast-enhanced Ultrasound with Perflubutane Following Percutaneous Liver Biopsy

Effectiveness and safety of CEUS-guided haemostatic injection for blunt splenic trauma: an animal experiment

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