Advanced Ultrasound in Diagnosis and Therapy ›› 2022, Vol. 6 ›› Issue (2): 39-47.doi: 10.37015/AUDT.2022.220017
• Review Article • Previous Articles Next Articles
Brenda E. Tester, BS, MSa, Ji-Bin Liu, MDb, John R. Eisenbrey, PhDb,*(), George Koenig, MDc
Received:
2022-04-18
Revised:
2022-04-30
Accepted:
2022-05-04
Online:
2022-06-30
Published:
2022-06-26
Contact:
John R. Eisenbrey, PhD,
E-mail:john.eisenbrey@jefferson.edu
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.
Table 1
Lesion dimensions measured by CEUS compared to CT grading. Modified from [7]."
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) |
Figure 1
17-year-old male admitted 6 hours after abdominal trauma. Grey-scale ultrasound (A) and color Doppler ultrasound (B) showed a cystic lesion (L) within the posterior lobe of the liver. Contrast ultrasound (C) demonstrated the anechoic lesion (L) with active bleeding (arrow) from the wall of the lesion which corresponded with CT findings (arrows) (D). [Provided by Drs. Xiang Jing and Jianming Ding from Tianjin Third Central Hospital]"
Figure 2
25-year-old female involved in a traffic accident. (A) Transverse oblique grey-scale US showed an injury site without clear boundaries in the middle of the spleen (arrow); (B) CEUS obtained from the same region showed the injury site in the middle of the spleen as an anechoic and hypoechoic perfusion defect (long arrows) with active bleeding (short arrow). SP, spleen. [Provided by Dr. Faqin Lv from Third Medical Center of Chinese PLA General Hospital]"
Figure 3
A male patient with left flank injury was admitted to hospital. Dual grey-scale (A) and contrast (B) ultrasound imaging detect an avascular perfusion defect at junction of mid and low poles which confirmed as kidney laceration at surgery. [Provided by Dr. Faqin Lv from Third Medical Center of Chinese PLA General Hospital]"
Figure 4
55-year-old man involved in a traffic accident. (A) CEUS identified the injury as an anechoic and hypoechoic perfusion defect with irregular borders in the pancreatic body/tail (arrows); (B) CT demonstrated the injury as a heterogenous, low-attenuation region (arrows) in the pancreatic body/tail, consistent with a hematoma and rupture of pancreas (P). [Provided by Dr. Faqin Lv from Third Medical Center of Chinese PLA General Hospital]"
Figure 5
Time-dependent changes on CEUS imaging using perfusion kinetics in the brain of a 9-month-old following cardiac arrest. (A) a coronal CEUS image 15 seconds after contrast injection, showing avid perfusion to the cortical region; (B) a coronal CEUS image 20 seconds after contrast injection, showing prolonged hyperperfusion to the peripheral gray and white matter; (C) Regions of interest selected; (D) unique perfusion kinetic curves generated in a region-specific manner. Reproduced from [42]."
Table 2
Selected indications for point-of-care contrast medium-enhanced ultrasonography. Modified from [46]."
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 |
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