Journal of Ultrasound in Medicine, Vol 17, Issue 10 609-616, Copyright © 1998 by American Institute of Ultrasound in Medicine
Evaluation of bleeding sites with a tissue-specific sonographic contrast agent: preliminary experiences in an animal model
B. B. Goldberg, D. A. Merton, J. B. Liu and F. Forsberg
Department of Radiology, Jefferson Ultrasound Research and Education Institute, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA.
The purpose of this study was to determine the feasibility and usefulness
of using an ultrasonographic contrast agent to enhance the sonographic
detection of bleeding sites in a canine model. SH U 563, an ultrasound
contrast agent that elicits acoustic emission (i.e., random transient
Doppler shifts produced by contrast particle rupture) even when stationary,
was used. Acoustic emission is identified as a mosaic pattern on color
Doppler imaging. A total of 13 active bleeding sites were created within
intraabdominal organs (kidney and spleen, n = 3), the urinary tract (n =
3), and the gastrointestinal tract (n = 7) in three canine models. Gray
scale and color Doppler imaging studies were performed prior to and after
each of 13 individual intravenous contrast agent administrations. Imaging
results were compared to gross pathologic findings. After contrast agent
administration, pooling of contrast medium-containing blood in the regions
adjacent to bleeding sites could be detected with color Doppler imaging as
regions with the characteristic acoustic emission color display. After
injection gray scale imaging failed to demonstrate the location or extent
of hemorrhaging adequately. A linear relationship existed between the blood
loss due to gastrointestinal tract bleeding and the amount of acoustic
emission detected (r2 = 0.81). SH U 563 combined with color Doppler imaging
improves the detection of bleeding sites in a variety of locations
throughout the body.
