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Appearance of Solid Organ Injury with Contrast-Enhanced Sonography in Blunt Abdominal Trauma: Preliminary Experience

¹ Department of Radiology, University of California, Davis School of Medicine, UC Davis Medical Center, 4860 Y St., Ste. 3100, Sacramento, CA 95817.
² Department of Emergency Medicine, University of California, Davis School of Medicine, UC Davis Medical Center, Sacramento, CA 95817.
³ Department of Surgery, University of California, Davis School of Medicine, UC Davis Medical Center, Sacramento, CA 95817.

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.

Keywords: abdominal imaging • contrast media • sonography • trauma

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