Comparison Of Contrast-enhanced Ultrasonography With CT In Diagnosis Of Acute Blunt Hepatic Trauma: An Animal Experiment

Objective To evaluate and compare the diagnostic value of contrast-enhanced ultrasonography(CEUS) with computed tomography (CT) in the diagnosis of acute blunt hepatic trauma.Methods Blunt hepatic trauma in forty-four white New Zealand rabbits was established with a steel ball falling down to the xiphoid process of animals.conventional ultrasonography, contrast-enhanced ultrasonography, plain and contrast helical CT scan were performed in the livers within 1 hour after injury. The presence and number of hepatic lesions, the hepatic capsular laceration,the size and margin of the lesions,active hemorrhage,the hemoperitoneum were evaluated , then were graded for the lesion severity on the Moore scale.Those findings were then compared with surgical and pathologic findings.Results The forty-four hepatic injuries were classified as Moore gradeâ… in seven rabbits,gradeâ…¡in thirteen rabbits,gradeâ…¢in twelve rabbits,gradeâ…£in nine rabbits,gradeâ…¤in three rabbits and twenty-nine hepatic capsular lacerations were detected by pathologic anatomy. During operation six ongoing bleeding and twenty-four Hemoperitoneum were found.The sensitivity and consistency of conventional ultrasonography ,CEUS, plain and contrast helical CT scan were 52.3%,0.15;84.1%,0.47;70.5%,0.28;93.2%,0.70 for demonstrating organ injury,respectively.The detectable rate of conventional ultrasonography,CEUS, plain and contrast helical CT scan were 51.7 %,75.9%,72.4%,89.4% for demonstrating hepatic capsular laceration, respectively. The underestimated rate and rank consistency of conventional ultrasonography,CEUS, plain and contrast helical CT scan were 77.1 % ,0.19; 37.5 % ,0.45; 52.1 % ,0.38;25.0 % ,0.67 for demonstrating hepatic injury grade, respectively. Ultrasonography and helical CT detected twenty-three,twenty-one hemoperitoneum, respectively. Both of CEUS and contrast helical CT detected four active hemorrhage.Conclusion 1.CEUS can improve the diagnostic level of ultrasound in the evaluation of acute blunt hepatic trauma;2.Comparing these four imaging examination in diagnosis of acute blunt hepatic trauma,contrast-enhanced CT might be still the most effective and followed by CEUS and then plain helical CT, conventional ultrasonography might be the final method;3.CEUS would be more appropriate valuable in the assessment of blunt hepatic trauma.