Faqin Lv, Abstract Co-Author: Nothing to Disclose

Jie Tang, Presenter: Nothing to Disclose

Yukun Luo MD, Abstract Co-Author: Nothing to Disclose

Jiangke Tian, Abstract Co-Author: Nothing to Disclose

Xia Xie, Abstract Co-Author: Nothing to Disclose

Tengfei Yu, Abstract Co-Author: Nothing to Disclose

Yu Ban, Abstract Co-Author: Nothing to Disclose

Tanshi Li, Abstract Co-Author: Nothing to Disclose

Li Yang, Abstract Co-Author: Nothing to Disclose

This study designed was to evaluate contrast enhanced ultrasound (CEUS) in identifying the presence, location and severity of splenic lesion, to explore imaging character of active bleeding (AB) from splenic trauma, and to analyze the CEUS value in rapid prediction surgery or non-operation of splenic trauma.

(1) Of 268 patients with suspected abdominal organ trauma, 128 cases were diagnosed as parenchymal organ injury including 58 spleen trauma. The CEUS findings were compared with those of contrast CT and/or surgery. (2) Thirty-four patients with splenic trauma were found to have contrast medium extravasation or pooling, indicating active bleeding. Special attention was paid to the presence, location, and character of the extravasated or pooled contrast medium. (3) Forty-five patients with spleen trauma received CEUS were analyzed. The CEUS predicted surgery and non-operation treatment.

(1) Spleen trauma accounted for 45.3% (58/128) who all underwent true rupture. CEUS showed spleen injury sites as anechoic/hypoechoic perfusion defects with an irregular borders and involved spleen capsules. The CEUS findings were consistent with those of contrast CT and/or surgery (P ＜0.001). (2) CEUS imaging of active bleeding in 34 patients with spleen injuries presented contrast medium extravasation or pooling in parenchyma and out of organ capsule, which were characterized by lesion contrast enhancing, multi-shape and activity. (3) The CEUS findings in all 45 patients were consistent with those of CT scanning (P ＜0.001). Of 45 cases, 20.0% (9/45) received conservative treatment, 53.3% (24/45) received percutaneous injection treatment under the guidance of CEUS and 26.7% (12/45) had to receive laparotomy by rapid classification.

CEUS can exactly identify the presence, location and severity of splenic lesion and show the active bleeding associated with splenic trauma at various of imaging characteristics, So it can predict surgery or non-operation of splenic trauma rapidly.

It is very important to identify immediately the presence, location and severity of splenic truama for manggement. CEUS presented a potential alternative with excellent imaging characteristics.

Lv, F, Tang, J, Luo, Y, Tian, J, Xie, X, Yu, T, Ban, Y, Li, T, Yang, L, Role of Contrast-enhanced Ultrasound in the Management of Spleen Trauma.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11010389.html