Emerging Applications of Contrast-enhanced Ultrasound in Trauma

doi:10.37015/AUDT.2022.220017

Abstract

Abstract:

The use of contrast-enhanced ultrasound (CEUS) has expanded over the past decade to include a variety of diagnostic and therapeutic applications. These include urgent clinical situations that require timely diagnosis and subsequent treatment. With the introduction of microbubble ultrasound contrast agents (UCAs), CEUS provides increased sensitivity and specificity over conventional ultrasound. Within the trauma setting, CEUS benefits include point of care imaging and an ability to monitor perfusion in real-time. Additionally, UCAs are non-nephrotoxic, and can be used when contrast enhanced CT is contraindicated. In this review, we discuss recent advancements of CEUS within trauma settings.

Key words: Contrast-enhanced ultrasound; Computed tomography; Abdominal trauma; Critical care; Bleeding

Brenda E. Tester, BS, MS, Ji-Bin Liu, MD, John R. Eisenbrey, PhD, George Koenig, MD. Emerging Applications of Contrast-enhanced Ultrasound in Trauma. Advanced Ultrasound in Diagnosis and Therapy, 2022, 6(2): 39-47.

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Item	CT grading^*	CEUS dimensions (mm)
Liver (n = 21)	Grade I: n = 3	<10 (n = 2)
	Grade II: n = 13	<20 (n = 4), <30 (n = 9)
	Grade III: n = 5	>30 (n = 5)
Spleen (n = 48)	Grade I: n = 4	<10 (n = 4)
	Grade II: n = 32	<30 (n = 11), <50 (n = 21)
	Grade III: n = 12	>50 (n = 12)
Kidney & adrenals (n = 13)	Grade I: n = 2	Not identified
	Grade II: n = 5	10 (n = 5)
	Grade III: n = 6	>10 (n = 6)
Pancreas (n = 2)	Grade II: n = 1	10 (n = 2)

Organ system	Potential indications
Cardiac	Left ventricle visualization, myocardial ischemia
Abdominal aorta	Abdominal aortic aneurysm (AAA) rupture, aortic dissection
Venous	Improved visualization of deep venous system
Lung	Differentiation between pneumonia and infarction
Kidney	Lacerations, hematomas, infarcts, abscesses, perfusion
Liver & biliary	Lacerations, hematomas, acute cholecystitis
Spleen	Lacerations, hematomas, infarcts
GI tract	Activity of Inflammatory bowel disease (IBD)
Scrotum	Testicular torsion/infarct, infections, hematomas
Musculoskeletal	Actively bleeding hematomas, compartment syndrome muscle perfusion