Splenic Trauma: Evaluation With Contrast-Specific Sonography and a Second-Generation Contrast Medium

Abstract

Contrast-enhanced sonography is a promising tool in the assessment of splenic trauma. In institutions where sonography is used as the initial procedure, this technique may increase its effectiveness.

Ultrasound enhanced with sulphur-hexafluoride-filled microbubbles agent (SonoVue) in the follow-up of mild liver and spleen trauma

“…With regard to less severe traumas, the literature data are controversial, with sensitivities of 90% and 41% both being reported. This remarkable variability depends not only on the operator's skill and patient's build but also on the patient's clinical status, which may limit cooperation; on the size and site of the lesion; and on the possible absence of intraperitoneal effusion [15,16].…”

“…Queste notevoli differenze nelle varie casistiche dipendono non solo dalle capacità dell'operatore e dalla costituzione fisica del paziente ma anche dalle condizioni cliniche del traumatizzato che possono limitarne la collaborazione, la grandezza e la sede della lesione e l'eventuale assenza di versamento intraperitoneale [15,16]. 776 Radiol med (2009) 114:771-779 perform whole-body CT for the purposes of neurological, thoracic and abdominal evaluation [13,14].…”

Contrast–enhanced ultrasound in trauma

“…In both in vitro studies and patient cases the bladder rupture was easily detected by microbubbles appearing in the liquid surrounding the urinary bladder. One recent publication [12] is the first that explicitly aims to evaluate contrast-enhanced ultrasound with second-generation microbubbles and parenchymal damage of the spleen in humans. In this study of preliminary data from 25 patients, contrast-enhanced ultrasound was much more effective than unenhanced ultrasound for assessment of the extent of injury, and there was a very good correlation between the results of contrast-enhanced ultrasound and those obtained with contrast-enhanced single-detector helical CT performed within 20 min after ultrasound.…”

Ultrasonography of the spleen. Pictorial essay

“…Fissures may be hyperechoic or hypoechoic compared to splenic parenchyma, contusions appear as slightly hypoechoic, ill-defined areas, and lacerations may be seen as clearly hypoechoic band, linear or branched, perpendicular to the splenic surface [2,20]. A fresh hematoma imposes a hyperechoic structural change within the splenic parenchyma, while an organized hematoma shows a varied echogenic structure, and a decreased or a lack of con-trast agent uptake at CEUS, better evident during the late phase of enhancement [1,21].…”

“…With CEUS the acute hemorrhages and pseudoaneurysms are indicated by an early-phase hyperechoic pool or jet within the splenic parenchyma or perisplenic hematomas (fig 11-14) [21].…”