title: Contrast-enhanced ultrasound assessment of muscle blood perfusion of extremities that underwent crush injury: an animal experiment.
abstract: BACKGROUND
  This research aimed to study the assessment of local muscle microcirculation perfusion of extremities that underwent crush injuries by using contrast-enhanced ultrasonography (CEUS).
  
  
  METHODS
  A total of 28 New Zealand rabbits were anesthetized by using intramuscular pentobarbital sodium (30 mg/kg). A balloon cuff device was used to create crush injuries to the left hind leg of each rabbit with a force of 18.6 kPa. CEUS was performed at the 0.5th, 2nd, 6th,24th, and 72nd hour after the release of the crush pressure. Peak intensity (PI) of the crushed regions was compared with those of the uncrushed regions and before the creation of crush injury. Receiver operating characteristic analysis was used to determine the diagnostic value of PI for the crushed region.
  
  
  RESULTS
  During the 72nd hour after the release of the crush pressure, 5 of the 28 rabbits died, and thus, their statistics were eliminated from the experiment. At different time points after the release of the crush pressure, the crushed regions in all 23 survivals showed quick and high enhancement, and their intensities were higher than those of the un crushed region in the arterial phase. The time-intensity curves of the crushed regions all appeared as rapid lift-gradual drop. PIs were obviously higher in the crushed regions than in the uncrushed regions and than those before the creation of crush injury ( p G 0.001). Receiver operating characteristic curves showed that extremity crush injury was diagnosed by using PI value.
  
  
  CONCLUSIONS
  CEUS presents that the microcirculation perfusion of the crushed muscle increased obviously after the release of the crush pressure.PIs evaluated quantitatively the microcirculation perfusion changes. It may suggest a potential alternative for evaluating microcirculation abnormality of the muscle crush injury to the extremities.
authors.affiliation: Department of Ultrasound, Chinese People's Liberation Army General Hospital, 28 Fuxing Rd, Beijing 100853, China. lvjin8912@163.com.
authors.forename: Faqin
authors.initials: F
authors.lastname: Lv
authors.forename: Jie
authors.initials: J
authors.lastname: Tang
authors.forename: Yukun
authors.initials: Y
authors.lastname: Luo
authors.forename: Yu
authors.initials: Y
authors.lastname: Ban
authors.forename: Rong
authors.initials: R
authors.lastname: Wu
authors.forename: Jiangke
authors.initials: J
authors.lastname: Tian
authors.forename: Tengfei
authors.initials: T
authors.lastname: Yu
authors.forename: Xia
authors.initials: X
authors.lastname: Xie
authors.forename: Tanshi
authors.initials: T
authors.lastname: Li
mesh_terms: D000818:Animals; D003287:Contrast Media; D003444:Crush Syndrome / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D006614:Hindlimb / Q000293:injuries*; D008297:Male; D008833:Microcirculation; D018482:Muscle, Skeletal / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000293:injuries*; D010743:Phospholipids; D011817:Rabbits; D013459:Sulfur Hexafluoride; D014463:Ultrasonography
chemical_list: D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride