Common and uncommon features of focal splenic lesions on contrast-enhanced ultrasound: a pictorial review

Zavariz, Julia; Konstantatou, Eleni; Deganello, Annamaria; Bosanac, Diana; Huang, Dean Y.; Sellars, Maria E.; Sidhu, Paul S.

doi:10.1590/0100-3984.2015.0209

Cited by 16 publications

(11 citation statements)

References 17 publications

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“…Its employment did increase the sensitivity of US techniques for recognizing traumatic abdominal lesions. These reached levels of accuracy are quite similar to those obtained with CT (up to 95%) [10][11][12].…”

Section: Us-ceussupporting

confidence: 82%

Role of contrast-enhanced ultrasound (CEUS) in the diagnosis and management of traumatic splenic injuries

et al. 2018

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Splenic injuries are common emergencies in the setting of abdominal trauma, as the spleen is the second most frequently injured abdominal organ after the liver. The treatment of splenic injuries underwent a severe shift from operative to nonoperative due to an increased awareness of the double physiological function, both immunological and hematological, of the spleen. This, in turn, led to an increased application of splenic preservation techniques. The non-operative approach has been strengthened through radiological imaging and interventional radiology. While multidetector computed tomography is mandatory in the evaluation of hemodynamically stable patients after high-energy trauma, one ultrasound (US) can be used as a first-line technique to examine patients in cases of low-energy trauma. Unfortunately, baseline US has low sensitivity in the detection of traumatic injuries. With the introduction of contrast-enhanced ultrasound (CEUS) as a reliable alternative to baseline ultrasound for low-grade abdominal trauma, the sensitivity of the US technique in recognizing traumatic abdominal lesions has strongly increased, reaching levels of accuracy similar to those of the CT. It has also been strongly recommended for use with children, as it allows for the performance of imaging techniques with the lowest dose of radiation possible. In this review, the authors aim to present the typical appearance of traumatic splenic injuries, using enhanced CEUS capability to overcome baseline US limits, and to describe the different techniques applied according to the hemodynamic stability of the patient. Keywords Trauma • Trauma imaging • Traumatic splenic injuries • Splenic trauma • Blunt abdominal trauma • BAT • Contrast-enhanced ultrasound • CEUS • Multidetector computed tomography • MDCT • Non-operative management Sommario La milza è il secondo organo più comunemente sede di trauma nel contesto dei traumi chiusi dell'addome. Nel corso degli ultimi decenni il trattamento dei traumi splenici ha subito un rapido shift verso un approccio sempre meno aggressivo. Il razionale alla base di questo trend sta nel duplice ruolo svolto da quest'organo dal punto di vista fisiologico, sia immunologico che ematologico, che ha portato allo sviluppo di manovre terapeutiche sempre più conservative. Questo approccio nonoperativo è stato fortemente sostenuto dalle nuove metodiche di imaging e dal rapido evolversi delle tecniche di radiologia interventistica. Dal punto di vista dell'imaging, mentre la TC Multidetector è mandatoria nella valutazione del paziente che ha subito un trauma ad elevata energia e stabile emodinamicamente, nei traumi a bassa energia l'ecografia può essere utilizzata come metodica di primo approccio. Sfortunatamente essa è caratterizzata da una bassa sensibilità nell' individuazione delle lesioni traumatiche a carico degli organi addominali. Con l'introduzione dell'ecografia con mezzo di contrasto (CEUS) come alternativa alla sola ecografia nella valutazione dei traumi a bassa energia, la sensibilità di tale metodica è no...

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Section: Us-ceussupporting

confidence: 82%

Role of contrast-enhanced ultrasound (CEUS) in the diagnosis and management of traumatic splenic injuries

et al. 2018

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“…CT Scan and MRI are imaging modalities that have very high sensitivity. Splenic abscess typically shows a thick irregular edge with hypodense in the middle, but multiple abscesses may be difficult to recognize (Krokos et al 2011, Zavariz et al 2017. In this case report, we presented a rare case about splenic abscess according to the literature.…”

Section: Discussionmentioning

confidence: 86%

Splenectomy for Aseptic Splenic Abscess

Pranata

Danardono

2021

FMI

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Highlight :A 26-year-old woman have sterile aerobic and anaerobic bacterial cultures.Pus and splenic tissue examination revealed no bacterial proliferation, while the surgery revealed a splenic abscess.Abstract:We presented a rare case, a 26-year-old woman have sterile aerobic and anaerobic bacterial cultures. Clinical examination of the patient showed a dense cystic mass in the left upper abdomen. Ultrasonography examination suspected a dermoid cyst. However, MRI examination of the abdomen showed turbid cystic lesions. The surgery revealed a splenic abscess, while pus and splenic tissue examination revealed no bacterial proliferation. Based on the literature, the patient had a good prognosis.

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“…This indicated that compared with conventional US and CDFI, CUES can more accurately and sensitively reflect the blood flow of the lesions. CEUS is a rapidly growing ultrasound technology that can visualize the low-speed blood flow and detect the perfusion characteristics in real time, thereby improving the diagnosis of splenic lesions [ 9 – 11 , 19 ]. Compared with contrast-enhanced computer tomography (CT) and contrast-enhanced magnetic resonance imaging (MRI), CEUS is a relatively safe, cost-effective, and time-saving technique.…”

Section: Discussionmentioning

confidence: 99%

Contrast-Enhanced Ultrasound Imaging Features of Focal Splenic Tuberculosis

Zhang

et al. 2021

Med Sci Monit

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Background The aim of this study was to characterize the contrast-enhanced ultrasound imaging features of focal splenic tuberculosis. Material/Methods We retrospectively analyzed the conventional ultrasound (US) and contrast-enhanced ultrasound (CEUS) imaging features of 22 patients with splenic TB confirmed by surgical histopathology or biopsy. Results Conventional US demonstrated that 15 of the 22 patients had a single lesion, while 7 had multiple lesions. The maximum diameter of the lesions ranged from 1.0 to 3.7 cm. Of the 22, 17 were detected with hypoecho and 5 were detected with complex echo by conventional US. Seven (7/22) were detected with blood flow signals by color Doppler flow image (CDFI). CUES demonstrated that 18 cases (81.8%, 18/22) began to enhance in the arterial phase, mostly followed by slow wash-out in the intermediate or late parenchymal phase, and 4 (18.2%, 4/22) presented with non-enhancement during all phases. The enhancement patterns were categorized into 4 types: Type I, homogeneous enhancement (2/22); Type II, rim-like enhancement (12/22); Type III, septation-like enhancement (4/22); and Type IV, non-enhancement (4/22). Conclusions CEUS showed that splenic TB lesions were enhanced in the arterial phase, followed by slow washed out or persistent enhancement in the intermediate and late parenchymal phases. The rim- or septation-like enhancement may be helpful for diagnosing splenic TB. The splenic lesions presenting round hypoecho by conventional US and complete non-enhancement by CEUS are highly suspicious of splenic TB.

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Common and uncommon features of focal splenic lesions on contrast-enhanced ultrasound: a pictorial review

Cited by 16 publications

References 17 publications

Role of contrast-enhanced ultrasound (CEUS) in the diagnosis and management of traumatic splenic injuries

Role of contrast-enhanced ultrasound (CEUS) in the diagnosis and management of traumatic splenic injuries

Splenectomy for Aseptic Splenic Abscess

Contrast-Enhanced Ultrasound Imaging Features of Focal Splenic Tuberculosis

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