title: Contrast-enhanced ultrasound imaging of active bleeding associated with hepatic and splenic trauma.
abstract: OBJECTIVE
  The aim of this study was to evaluate contrast-enhanced ultrasound (CEUS) imaging of active bleeding from hepatic and splenic trauma.
  
  
  METHODS
  Three hundred and ninety-two patients with liver or/and spleen trauma (179 liver and 217 spleen injuries), who underwent CEUS examinations following contrast-enhanced computed tomography (CT), were enrolled in this retrospective study over a period of >4 years. CEUS detected contrast medium extravasation or pooling in 16% (63/396) of liver or spleen lesions in 61 patients, which was confirmed by contrast-enhanced CT. Special attention was paid to observing the presence, location, and characteristics of the extravasated or pooled contrast medium.
  
  
  RESULTS
  The CEUS detection rate for active bleeding was not different from that of contrast-enhanced CT (p=0.333). Information from surgery, minimally invasive treatment and conservative treatment was used as reference standard, and the sensitivities of the two techniques were not different (p=0.122). Of 63 lesions in 61 patients, CEUS showed that 74.6% (47/63) (21 liver lesions and 26 spleen lesions) presented contrast medium extravasation or pooling, both in the organ and out the capsule, in 14.3% (9/63) and only outside the capsule in 11.1% (7/63). CEUS imaging of active bleeding from hepatic and splenic trauma presented various characteristics, and the sizes and shapes of the active bleeding due to contrast medium extravasation or pooling were variable.
  
  
  CONCLUSIONS
  CEUS can show the active bleeding associated with hepatic and splenic trauma with various imaging characteristics, thus making it possible to diagnose active bleeding using CEUS.
authors.affiliation: Department of Ultrasound, Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Beijing 100853, China.
authors.forename: F
authors.initials: F
authors.lastname: Lv
authors.forename: J
authors.initials: J
authors.lastname: Tang
authors.forename: Y
authors.initials: Y
authors.lastname: Luo
authors.forename: Z
authors.initials: Z
authors.lastname: Li
authors.forename: X
authors.initials: X
authors.lastname: Meng
authors.forename: Z
authors.initials: Z
authors.lastname: Zhu
authors.forename: T
authors.initials: T
authors.lastname: Li
mesh_terms: D000007:Abdominal Injuries / Q000150:complications* / Q000000981:diagnostic imaging; D003287:Contrast Media; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006470:Hemorrhage / Q000000981:diagnostic imaging* / Q000209:etiology*; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging* / Q000293:injuries; D008297:Male; D010743:Phospholipids; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013154:Spleen / Q000000981:diagnostic imaging* / Q000293:injuries; D013459:Sulfur Hexafluoride; D014057:Tomography, X-Ray Computed; D014949:Wounds, Nonpenetrating / Q000150:complications / Q000000981:diagnostic imaging*
chemical_list: D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride