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© 2008 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 27:925-932 • 0278-4297

Technical Advance

Percutaneous Injection Therapy for Blunt Splenic Trauma Guided by Contrast-Enhanced Ultrasonography

Jie Tang, MD, Huiqin Zhang, MD, Faqin Lv, MD, Wenxiu Li, MD, Yukun Luo, MD, Yuexiang Wang, MD and Junlai Li, MD

Department of Ultrasound, Chinese People’s Liberation Army General Hospital, Beijing, China.

Address correspondence to Jie Tang, MD, Department of Ultrasound, Chinese People’s Liberation Army General Hospital, 28 Fuxing Rd, 100853 Beijing, China. E-mail: txiner{at}vip.sina.com

Objective. The purpose of this study was to investigate the application of contrast-enhanced ultrasonography (CEUS) in managing blunt splenic trauma and the effectiveness of CEUS-guided percutaneous injection therapy. Methods. Six patients with grade 3 or 4 splenic injuries as determined by CEUS and contrast-enhanced computed tomography were given hemocoagulase atrox and absorbable cyanoacrylate percutaneously, which were injected into the injury region and active bleeding site, respectively, under CEUS guidance. Immediately after the procedure and 1 and 3 days, 1 and 2 weeks, and 1 and 6 months after the procedure, follow-up CEUS up was performed in all patients. Results. Among the 6 patients, 4 cases of CEUS-guided hemostatic injection were successful without complications. Rehemorrhage occurred in 1 patient, and a traumatic arteriovenous fistula occurred in another; repeated injection therapy in these 2 patients was effective. During the follow-up, there were no complications, and spleen perfusion recovered gradually. Conclusions. Contrast-enhanced ultrasonography can be used to guide percutaneous injection therapy and therefore achieve the goal of using interventional ultrasonography in managing splenic trauma.

Key Words: contrast-enhanced ultrasonography • management • trauma • ultrasonography

Abbreviations: CEUS, contrast-enhanced ultrasonography • CPS, contrast pulse sequencing • CT, computed tomography • MVD, microvascular density

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