Experimental Study on Retroperitoneal Artery Bleeding with Contrast-Enhanced Ultrasound

BackgroundWe lack noninvasive and effective methods for evaluating origin of pelvic hemorrhage. Contrast-enhanced ultrasound (CEUS) may be a prospective method.ObjectiveWe aimed to investigate the diagnostic value of CEUS on external iliac artery (EIA) bleeding in rabbits.MethodsFourteen rabbits were evenly divided into small- and big-crevasse groups. EIAs of rabbits in the small-crevasse group were punctured with a 12-G needle via femoral arterial cannulation. After puncture, the crevasse of EIAs of rabbits in the big-crevasse group was enlarged with a dilator. CEUS was performed 2, 10, and 40 min after artery injury. Digital subtraction angiography (DSA) was performed 20 and 30 min after injury.ResultsA massive enhancement region in the retroperitoneal space adjacent to the injured EIA and a jet at the site of the crevasse were observed on intravenous CEUS within 2 min after injury in all rabbits of the two groups. Contrast-agent extravasation verified by DSA was detected in all rabbits of the big-crevasse group on CEUS of 10 min and 40 min after injury with significant lower velocity (p < 0.05). In the small-crevasse group, four rabbits displayed contrast-agent extravasation on CEUS of 10 min and none on CEUS of 40 min after injury, however, six rabbits and one rabbit exhibited contrast-agent extravasation on DSA of 20 min and 30 min after injury, respectively.ConclusionsThe accuracy of CEUS in detecting active bleeding of peritoneal artery was high. Pulsed Doppler guided by CEUS was able to distinguish arterial from venous blood flow and to exhibit the velocity changes.