caa a22 4500 605540160 CHVBK 20210128100910.0 cr unu---uuuuu 210128e20150401xx s 000 0 eng 10.1007/s10396-014-0601-5 doi (NATIONALLICENCE)springer-10.1007/s10396-014-0601-5 Contrast-enhanced ultrasound for evaluation of renal trauma during acute hemorrhagic shock: a canine model [Elektronische Daten] [Qian Lin, Faqin Lv, Yukun Luo, Qing Song, Qinghua Xu, Yihua Su, Yu Tang, Jie Tang] 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. The Japan Society of Ultrasonics in Medicine, 2014 Kidney nationallicence Trauma nationallicence Active bleeding nationallicence Hemorrhagic shock nationallicence Contrast-enhanced ultrasonography nationallicence Lin Qian Department of Ultrasound, Chinese People's Liberation Army General Hospital, No. 28 Fuxing Rd, 100853, Beijing, China aut Lv Faqin Department of Ultrasound, Chinese People's Liberation Army General Hospital, No. 28 Fuxing Rd, 100853, Beijing, China aut Luo Yukun Department of Ultrasound, Chinese People's Liberation Army General Hospital, No. 28 Fuxing Rd, 100853, Beijing, China aut Song Qing Department of Ultrasound, Chinese People's Liberation Army General Hospital, No. 28 Fuxing Rd, 100853, Beijing, China aut Xu Qinghua Department of Ultrasound, Chinese People's Liberation Army General Hospital, No. 28 Fuxing Rd, 100853, Beijing, China aut Su Yihua Department of Function, Tumor Hospital of Datong Coal Mine Group Limited Liability Company, 1 Xinsheng Rd, 037003, Datong, Shanxi, China aut Tang Yu Department of Ultrasound, 62th Hospital of Chinese People's Liberation Army, 3 Yushui Rd, 665000, Puer, Yunnan, China aut Tang Jie Department of Ultrasound, Chinese People's Liberation Army General Hospital, No. 28 Fuxing Rd, 100853, Beijing, China aut Journal of Medical Ultrasonics Springer Japan 42/2(2015-04-01), 199-205 1346-4523 42:2<199 2015 42 10396 https://doi.org/10.1007/s10396-014-0601-5 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10396-014-0601-5 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Lin Qian Department of Ultrasound, Chinese People's Liberation Army General Hospital, No. 28 Fuxing Rd, 100853, Beijing, China aut NATIONALLICENCE 700 1- Lv Faqin Department of Ultrasound, Chinese People's Liberation Army General Hospital, No. 28 Fuxing Rd, 100853, Beijing, China aut NATIONALLICENCE 700 1- Luo Yukun Department of Ultrasound, Chinese People's Liberation Army General Hospital, No. 28 Fuxing Rd, 100853, Beijing, China aut NATIONALLICENCE 700 1- Song Qing Department of Ultrasound, Chinese People's Liberation Army General Hospital, No. 28 Fuxing Rd, 100853, Beijing, China aut NATIONALLICENCE 700 1- Xu Qinghua Department of Ultrasound, Chinese People's Liberation Army General Hospital, No. 28 Fuxing Rd, 100853, Beijing, China aut NATIONALLICENCE 700 1- Su Yihua Department of Function, Tumor Hospital of Datong Coal Mine Group Limited Liability Company, 1 Xinsheng Rd, 037003, Datong, Shanxi, China aut NATIONALLICENCE 700 1- Tang Yu Department of Ultrasound, 62th Hospital of Chinese People's Liberation Army, 3 Yushui Rd, 665000, Puer, Yunnan, China aut NATIONALLICENCE 700 1- Tang Jie Department of Ultrasound, Chinese People's Liberation Army General Hospital, No. 28 Fuxing Rd, 100853, Beijing, China aut NATIONALLICENCE 773 0- Journal of Medical Ultrasonics Springer Japan 42/2(2015-04-01), 199-205 1346-4523 42:2<199 2015 42 10396