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© 2008 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 27:867-874 • 0278-4297

Hemostasis of Active Bleeding From the Liver With Percutaneous Microwave Coagulation Therapy Under Contrast-Enhanced Ultrasonographic Guidance

An Experimental Study

Hong-Ping Song, PhD, Ming Yu, PhD, Jun Zhang, PhD, Zeng-Hui Han, PhD, Hai-Li Su, PhD, Xiao-Long Ren, PhD, Zhang-Rui Wei, PhD, Wen Luo, PhD, Jian-Guo He, BS and Xiao-Dong Zhou, PhD

Department of Ultrasound, Xijing Hospital, Fourth Military Medical University, Xi’an, China.

Address correspondence to Xiao-Dong Zhou, PhD, Department of Ultrasound, Xijing Hospital, Fourth Military Medical University, 17 W Changle Rd, 710032 Xi’an, China. E-mail: songhp{at}hotmail.com

Objective. The purpose of this study was to investigate the feasibility of percutaneous microwave coagulation therapy (PMCT) guided by contrast-enhanced ultrasonography (CEUS) for controlling active bleeding in rabbit livers. Methods. Twenty actively bleeding rabbit liver models, produced with an 18-gauge semiautomatic biopsy needle and confirmed with CEUS, were randomly divided into 2 groups: a PMCT group (n = 10, with a microwave antenna placed into the bleeding site under ultra-sonographic guidance and worked at 60 W for 30 seconds on average) and a control group (n = 10, with the active bleeding site not treated). After therapy procedures were performed, lactated Ringer’s solution resuscitation was then performed in both groups to maintain the mean arterial pressure at 70 mm Hg for 1 hour. The intraperitoneal blood loss, total resuscitation volume, mean arterial pressure, and hematocrit value were recorded. Macroscopic and microscopic examinations were performed at the end of the study. Results. After PMCT, the former bleeding site appeared on CEUS as a round or an oval area devoid of contrast. The PMCT group had lower blood loss (30.4 ± 7.2 versus 101.6 ± 18.2 mL; P < .05) and a lower total resuscitation volume (56.5 ± 10 versus 186 ± 36.6 mL; P < .05) than the control group. The mean hematocrit value in the PMCT group was significantly higher than that in the control group (26% ± 4% versus 19% ± 4%; P < .05) at the end of the experiment. Conclusions. Contrast-enhanced ultrasonographically guided PMCT significantly decreased blood loss in a rabbit model of active liver bleeding. It provides a simple and quick method to control blood loss in liver injuries with active bleeding.

Key Words: active bleeding • contrast-enhanced ultrasonography • liver • percutaneous microwave coagulation therapy

Abbreviations: CEUS, contrast-enhanced ultrasonography • Hct, hemat-ocrit • MAP, mean arterial pressure • PMCT, percutaneous microwave coagulation therapy

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Copyright © 2008 by the American Institute of Ultrasound in Medicine.