Contrast-enhanced ultrasound for evaluation of renal trauma during acute hemorrhagic shock: a canine model

Verfasser / Beitragende:
[Qian Lin, Faqin Lv, Yukun Luo, Qing Song, Qinghua Xu, Yihua Su, Yu Tang, Jie Tang]
Ort, Verlag, Jahr:
2015
Enthalten in:
Journal of Medical Ultrasonics, 42/2(2015-04-01), 199-205
Format:
Artikel (online)
ID: 605540160
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024 7 0 |a 10.1007/s10396-014-0601-5  |2 doi 
035 |a (NATIONALLICENCE)springer-10.1007/s10396-014-0601-5 
245 0 0 |a Contrast-enhanced ultrasound for evaluation of renal trauma during acute hemorrhagic shock: a canine model  |h [Elektronische Daten]  |c [Qian Lin, Faqin Lv, Yukun Luo, Qing Song, Qinghua Xu, Yihua Su, Yu Tang, Jie Tang] 
520 3 |a Purpose: Contrast-enhanced ultrasound (CEUS) is a highly specific and sensitive method for assessing hemodynamically stable patients with blunt abdominal trauma. We evaluated the efficacy of CEUS in assessing renal trauma in different states of hemodynamic instability or shock. Methods: Hemorrhagic renal lesions reflecting grade III-IV trauma were established in the kidneys of 25 mongrel dogs. Mild, moderate, and severe systemic hypotension was induced by controlled exsanguination. The features of renal trauma in CEUS and contrast-enhanced computed tomography (CECT) were assessed and compared before shock and during shock progression. Results: Gross pathology showed that with trauma, the kidneys gradually shrank and became soft, and the active bleeding in the area of the renal trauma gradually reduced and stopped. No significant differences were observed in the trauma detection rates between CEUS and CECT at any stage of shock. During the baseline and mild shock stage, sonograms obtained after intravenous injection of contrast agent showed marked contrast medium extravasation and pooling at the site of active bleeding. With shock progression, the difference in enhancement between trauma areas and the surrounding renal tissue decreased: the trauma areas became indistinct and the abnormal enhancement associated with active bleeding diminished. Further, CEUS enabled visualization of changes in renal perfusion associated with shock progression. Changes in contrast agent arrival time and the time to peaking were observed earliest in the mild shock model. The contrast agent peak intensity reduced, while the washout time increased as shock progressed from moderate to severe. Conclusion: In our canine model, CEUS was found to be as accurate as CECT in assessing hemorrhagic renal lesions. Thus, CEUS seems a promising tool for monitoring hemodynamic changes and predicting early shock to enable the conservative treatment of severe renal trauma. 
540 |a The Japan Society of Ultrasonics in Medicine, 2014 
690 7 |a Kidney  |2 nationallicence 
690 7 |a Trauma  |2 nationallicence 
690 7 |a Active bleeding  |2 nationallicence 
690 7 |a Hemorrhagic shock  |2 nationallicence 
690 7 |a Contrast-enhanced ultrasonography  |2 nationallicence 
700 1 |a Lin  |D Qian  |u Department of Ultrasound, Chinese People's Liberation Army General Hospital, No. 28 Fuxing Rd, 100853, Beijing, China  |4 aut 
700 1 |a Lv  |D Faqin  |u Department of Ultrasound, Chinese People's Liberation Army General Hospital, No. 28 Fuxing Rd, 100853, Beijing, China  |4 aut 
700 1 |a Luo  |D Yukun  |u Department of Ultrasound, Chinese People's Liberation Army General Hospital, No. 28 Fuxing Rd, 100853, Beijing, China  |4 aut 
700 1 |a Song  |D Qing  |u Department of Ultrasound, Chinese People's Liberation Army General Hospital, No. 28 Fuxing Rd, 100853, Beijing, China  |4 aut 
700 1 |a Xu  |D Qinghua  |u Department of Ultrasound, Chinese People's Liberation Army General Hospital, No. 28 Fuxing Rd, 100853, Beijing, China  |4 aut 
700 1 |a Su  |D Yihua  |u Department of Function, Tumor Hospital of Datong Coal Mine Group Limited Liability Company, 1 Xinsheng Rd, 037003, Datong, Shanxi, China  |4 aut 
700 1 |a Tang  |D Yu  |u Department of Ultrasound, 62th Hospital of Chinese People's Liberation Army, 3 Yushui Rd, 665000, Puer, Yunnan, China  |4 aut 
700 1 |a Tang  |D Jie  |u Department of Ultrasound, Chinese People's Liberation Army General Hospital, No. 28 Fuxing Rd, 100853, Beijing, China  |4 aut 
773 0 |t Journal of Medical Ultrasonics  |d Springer Japan  |g 42/2(2015-04-01), 199-205  |x 1346-4523  |q 42:2<199  |1 2015  |2 42  |o 10396 
856 4 0 |u https://doi.org/10.1007/s10396-014-0601-5  |q text/html  |z Onlinezugriff via DOI 
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900 7 |a Metadata rights reserved  |b Springer special CC-BY-NC licence  |2 nationallicence 
908 |D 1  |a research-article  |2 jats 
949 |B NATIONALLICENCE  |F NATIONALLICENCE  |b NL-springer 
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950 |B NATIONALLICENCE  |P 700  |E 1-  |a Lin  |D Qian  |u Department of Ultrasound, Chinese People's Liberation Army General Hospital, No. 28 Fuxing Rd, 100853, Beijing, China  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Lv  |D Faqin  |u Department of Ultrasound, Chinese People's Liberation Army General Hospital, No. 28 Fuxing Rd, 100853, Beijing, China  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Luo  |D Yukun  |u Department of Ultrasound, Chinese People's Liberation Army General Hospital, No. 28 Fuxing Rd, 100853, Beijing, China  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Song  |D Qing  |u Department of Ultrasound, Chinese People's Liberation Army General Hospital, No. 28 Fuxing Rd, 100853, Beijing, China  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Xu  |D Qinghua  |u Department of Ultrasound, Chinese People's Liberation Army General Hospital, No. 28 Fuxing Rd, 100853, Beijing, China  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Su  |D Yihua  |u Department of Function, Tumor Hospital of Datong Coal Mine Group Limited Liability Company, 1 Xinsheng Rd, 037003, Datong, Shanxi, China  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Tang  |D Yu  |u Department of Ultrasound, 62th Hospital of Chinese People's Liberation Army, 3 Yushui Rd, 665000, Puer, Yunnan, China  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Tang  |D Jie  |u Department of Ultrasound, Chinese People's Liberation Army General Hospital, No. 28 Fuxing Rd, 100853, Beijing, China  |4 aut 
950 |B NATIONALLICENCE  |P 773  |E 0-  |t Journal of Medical Ultrasonics  |d Springer Japan  |g 42/2(2015-04-01), 199-205  |x 1346-4523  |q 42:2<199  |1 2015  |2 42  |o 10396