Appearance of solid organ injury with contrast-enhanced sonography in blunt abdominal trauma: Preliminary experience
Appearance of solid organ injury with contrast-enhanced sonography in blunt abdominal trauma: Preliminary experience
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DOI：
10.2214/ajr.05.0946
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发表时间：
2006-09-01
影响因子：
5
通讯作者：
Holmes, James F.
中科院分区：
文献类型：
--
作者：
McGahan, John P.;Horton, Stephanie;Holmes, James F.
OBJECTIVE.本研究的目的是比较在确认实体器官损伤的情况下，对比增强超声和非对比增强超声的损伤检出率和特征性成像结果。这项前瞻性研究涉及在对比增强CT上识别肝、脾和肾损伤。损伤识别后，进行非对比增强超声检查和对比增强超声检查，以识别可能的损伤并分析损伤的外观。然后分析肝、脾和肾损伤的超声表现，并将损伤的显著性从0（不可见）到3（高度可见）进行分级。非对比增强超声显示11（50%）22损伤，而对比增强超声显示20（91%）22损伤。与对比增强超声相比，脾脏损伤和肝脏损伤的损伤明显性平均等级分别从0.67增加到2.33和1.0增加到2.2，等级从0（非可视化）到3（高度可视化）。脾损伤表现为低回声，在超声造影下，撕裂伤内偶见正常增强的脾组织。在肝损伤中观察到不同的模式，包括中央低回声区。部分肝损伤周围有强回声区。与非超声造影相比，超声造影可大大增强肝脏和脾脏损伤的显示。实质性器官损伤在超声造影上通常表现为低回声，但损伤周围的高回声区也常被识别为肝损伤。
OBJECTIVE. The purpose of this study was to compare the detection rate of injury and characterize imaging findings of contrast-enhanced sonography and non-contrast-enhanced sonography in the setting of confirmed solid organ injury.SUBJECTS AND METHODS. This prospective study involved identifying hepatic, splenic, and renal injuries on contrast-enhanced CT. After injury identification, both non-contrast-enhanced sonography and contrast-enhanced sonography were performed to identify the possible injury and to analyze the appearance of the injury. The sonographic appearance of hepatic, splenic, and renal injuries was then analyzed, and the conspicuity of the injuries was graded on a scale from 0 (nonvisualization) to 3 (high visualization).RESULTS. Non-contrast-enhanced sonography revealed 11 (50%) of 22 injuries, whereas contrast-enhanced sonography depicted 20 (91%) of 22 injuries. The average grade for conspicuity of injuries was increased from 0.67 to 2.33 for spleen injuries and from 1.0 to 2.2 for liver injuries comparing non-contrast-enhanced with contrast-enhanced sonography, respectively, on a scale from 0, being nonvisualization, to 3, being high visualization. The splenic injuries appeared hypoechoic with occasional areas of normal enhancing splenic tissue within the laceration with contrast-enhanced sonography. Different patterns were observed in liver injuries including a central hypoechoic region. In some liver injuries there was a surrounding hyperechoic region.CONCLUSION. Contrast-enhanced sonography greatly enhances visualization of liver and spleen injuries compared with non-contrast-enhanced sonography. Solid organ injuries usually appeared hypoechoic on contrast-enhanced sonography, but often a hyperechoic region surrounding the injury also was identified with liver injuries.