Contrast-enhanced ultrasound for evaluation of renal trauma during acute hemorrhagic shock: a canine model

Lin, Qi; Lv, Faqin; Luo, Yukun; Song, Qing; Xu, Qian; Su, Yihua; Yu, Tinghe; Tang, Jie

doi:10.1007/s10396-014-0601-5

Cited by 6 publications

(8 citation statements)

References 17 publications

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“…CEUS is a technology that enables real-time observation of the status of the lesion and the blood perfusion of its adjacent tissues through intravenous injection of a US contrast agent under low mechanical index. CEUS has been widely used in the examination of the liver, uterus, prostate and other organs (9,10). With the upgrading of superficial instrumentation and development of imaging techniques, clinical applications of thyroid contrast US are also increasing (11–21).…”

Section: Discussionmentioning

confidence: 99%

Shear wave elastography and contrast-enhanced ultrasonography in the diagnosis of thyroid malignant nodules

Chen

Zhang

et al. 2016

Molecular and Clinical Oncology

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The aim of the present study was to evaluate the value of shear wave elastography (SWE) and contrast-enhanced ultrasonography (CEUS) in the diagnosis of thyroid malignant nodules. A total of 253 patients with 319 thyroid nodules were subjected to two-dimensional ultrasound (2DUS) and CEUS examinations prior to thyroidectomy between March, 2014 and December, 2015. Young's modulus value for each nodule on 2DUS and CEUS images were recorded. The sensitivity, specificity and accuracy of 2DUS, SWE and CEUS in the diagnosis of thyroid malignant nodules were assessed. The results demonstrated that, of the 319 nodules that were pathologically confirmed, 183 were malignant and 136 were benign. The area under the receiver operating characteristic curve as a result of SWE diagnosis was 0.77. When the threshold of the Young's modulus value was ≥27.65 kPa in the diagnosis of malignant thyroid nodules, SWE exhibited a sensitivity of 84.55% (115/136), a specificity of 84.15% (154/183) and an accuracy of 84.32% (269/319). US contrast imaging of malignant thyroid nodules revealed a major tendency for early hypoenhancement and hypoenhancement. CEUS exhibited a sensitivity of 87.5% (119/136), a specificity of 86.33% (158/183) and an accuracy of 86.83% (277/319) in the diagnosis of malignant thyroid nodules. Compared with 2DUS, SWE, CEUS and their combined use exhibited statistically significant differences in the diagnosis of thyroid malignant nodules in terms of sensitivity, specificity and accuracy (χ2=9.220,15.310 and 40.296, respectively; P=0.000); SWE or CEUS did not differ significantly in the diagnosis of thyroid malignant nodules in terms of sensitivity, specificity or accuracy (χ2=0.737;P=0.542); Compared with the use of SWE or CEUS alone, their combination exhibited statistically significant differences in the diagnosis of malignant thyroid nodules in terms of sensitivity, specificity and accuracy (χ2=12.264 and 6.939, respectively; P=0.000,0.005). In conclusion, the high accuracy of the combined use of SWE and CEUS in the diagnosis of malignant thyroid nodules is of great clinical value.

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Section: Discussionmentioning

confidence: 99%

Shear wave elastography and contrast-enhanced ultrasonography in the diagnosis of thyroid malignant nodules

Chen

Zhang

et al. 2016

Molecular and Clinical Oncology

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“…Hemorrhagic shock reduced cortical renal perfusion as determined by IDF microscopy [ 9 ] and blood loss > 35% of circulating volume deteriorated renal perfusion as measured by invasive laser Doppler flowmetry [ 27 ]. Here, we show the applicability of a non-invasive imaging technique, contrast-enhanced ultrasonography, which can be used in the clinical setting to determine hemorrhagic shock-induced renal perfusion disturbances [ 28 , 29 ]. Importantly, the effect of hemorrhagic shock on microcirculatory perfusion in the present study was tissue-specific as renal perfusion was more severely affected by hemorrhagic shock than cremaster perfusion with a reduction in perfusion of 80% versus 57%, respectively, compared to baseline values.…”

Section: Discussionmentioning

confidence: 99%

The effect of targeting Tie2 on hemorrhagic shock-induced renal perfusion disturbances in rats

Leeuwen

Dekker

Slyke³

et al. 2021

ICMx

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Background Hemorrhagic shock is associated with acute kidney injury and increased mortality. Targeting the endothelial angiopoietin/Tie2 system, which regulates endothelial permeability, previously reduced hemorrhagic shock-induced vascular leakage. We hypothesized that as a consequence of vascular leakage, renal perfusion and function is impaired and that activating Tie2 restores renal perfusion and function. Methods Rats underwent 1 h of hemorrhagic shock and were treated with either vasculotide or PBS as control, followed by fluid resuscitation for 4 h. Microcirculatory perfusion was measured in the renal cortex and cremaster muscle using contrast echography and intravital microscopy, respectively. Changes in the angiopoietin/Tie2 system and renal injury markers were measured in plasma and on protein and mRNA level in renal tissue. Renal edema formation was determined by wet/dry weight ratios and renal structure by histological analysis. Results Hemorrhagic shock significantly decreased renal perfusion (240 ± 138 to 51 ± 40, p < 0.0001) and cremaster perfusion (12 ± 2 to 5 ± 2 perfused vessels, p < 0.0001) compared to baseline values. Fluid resuscitation partially restored both perfusion parameters, but both remained below baseline values (renal perfusion 120 ± 58, p = 0.08, cremaster perfusion 7 ± 2 perfused vessels, p < 0.0001 compared to baseline). Hemorrhagic shock increased circulating angiopoietin-1 (p < 0.0001), angiopoietin-2 (p < 0.0001) and soluble Tie2 (p = 0.05), of which angiopoietin-2 elevation was associated with renal edema formation (r = 0.81, p < 0.0001). Hemorrhagic shock induced renal injury, as assessed by increased levels of plasma neutrophil gelatinase-associated lipocalin (NGAL: p < 0.05), kidney injury marker-1 (KIM-1; p < 0.01) and creatinine (p < 0.05). Vasculotide did not improve renal perfusion (p > 0.9 at all time points) or reduce renal injury (NGAL p = 0.26, KIM-1 p = 0.78, creatinine p > 0.9, renal edema p = 0.08), but temporarily improved cremaster perfusion at 3 h following start of fluid resuscitation compared to untreated rats (resuscitation + 3 h: 11 ± 3 vs 8 ± 3 perfused vessels, p < 0.05). Conclusion Hemorrhagic shock-induced renal impairment cannot be restored by standard fluid resuscitation, nor by activation of Tie2. Future treatment strategies should focus on reducing angiopoietin-2 levels or on activating Tie2 via an alternative strategy.

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“…This study was conducted according to the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of The First Affiliated Hospital of Anhui Medical University (PJ2019- [17][18][19]. All participants provided written informed consent.…”

Section: Ethics Approvalmentioning

confidence: 99%

“…Hemodynamic stability was a vital factor for severity assessment and management in trauma, 12,13 and CEUS was proved feasible to evaluate active hemorrhage around the injuries of solid organ with significant specificity and sensitivity. [14][15][16] Moreover, Xu et al 17 have successfully applied real-time 3-dimensional CEUS to detect hemorrhage in blunt renal trauma of New Zealand white rabbits, and Lin et al 18 have found CEUS sensitive in evaluating hemorrhagic renal lesions in shock or different status of hemodynamic instability in a canine model, which pushed us to consider CEUS as a new approach to display the possible bleeding or exudation from the wound which might be a probable indicator to wound healing.…”

Section: Introductionmentioning

confidence: 99%

Application of Contrast-Enhanced Ultrasonography (CEUS) in the Assessment of Kidney Wound Recovery After Nephron-Sparing Surgery

Liang

et al. 2021

CMAR

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To investigate feasibility, repeatability and usefulness of contrast-enhanced ultrasonography (CEUS) in the assessment of kidney wound recovery after laparoscopic nephronsparing surgery (LNSS) or robot-assisted nephron-sparing surgery (RANSS) and preliminarily research the clinical factors associated with the length of extravasation (LOE). Patients and Methods: From April 2019 to January 2020, 130 patients that underwent LNSS or RANSS in our hospital were included, and 90 patients (90/130) received CEUS examinations each one day from the postoperative day 1. The discovery of the cessation of contrast medium extravasation from the renal wound was the primary endpoint named "ultrasonic healing", and LOE ranged from the day of surgery to "ultrasonic healing". Patient, tumor, perioperative factors and LOE were collected. Univariate analysis and multivariate linear regression analysis were applied for the determination of factors associated with LOE. Results: The average postoperative LOE was 1.76 days (standard deviation, 1.115; 95% confidence interval: 1.52-1.99). Ultrasonic healing within three days was observed in 95.6% patients (86/90). Univariable and multivariable analyses showed that R and A components in R.E.N.A.L. nephrometry score were associated with LOE. Anterior location and R component score of 2 (tumor size>4cm) were related to longer LOE than posterior location and R score of 1 (tumor size<4cm). The incidence of complications in patients with LOE over one day was higher than those with LOE of one day. Conclusion: CEUS was feasible, repeatable and useful in the assessment of kidney wound recovery. Tumor size and location were related to LOE after minimally invasive nephron-sparing surgery (MINSS). Length of stay after MINSS within three days might be relatively safe.

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Contrast-enhanced ultrasound for evaluation of renal trauma during acute hemorrhagic shock: a canine model

Abstract: In our canine model, CEUS was found to be as accurate as CECT in assessing hemorrhagic renal lesions. Thus, CEUS seems a promising tool for monitoring hemodynamic changes and predicting early shock to enable the conservative treatment of severe renal trauma.

Cited by 6 publications

References 17 publications

Shear wave elastography and contrast-enhanced ultrasonography in the diagnosis of thyroid malignant nodules

Shear wave elastography and contrast-enhanced ultrasonography in the diagnosis of thyroid malignant nodules

The effect of targeting Tie2 on hemorrhagic shock-induced renal perfusion disturbances in rats

Application of Contrast-Enhanced Ultrasonography (CEUS) in the Assessment of Kidney Wound Recovery After Nephron-Sparing Surgery

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