Comparison of transcutaneous contrast-enhanced ultrasound-guided injected hemostatic agents with traditional surgery treatment for liver, spleen and kidney trauma: a retrospective study.

BACKGROUND/AIMS: There is lack of studies on the effectiveness of transcutaneous contrast-enhanced ultrasound-guided injections of hemostatic agents for liver. spleen and kidney trauma. We compared treatment by hemostatic agents to surgical treatment in a retrospective interventional human study. METHODOLOGY: The study enrolled a total of 135 subjects from emergency unit of the Chinese People's Liberation Army General Hospital in Beijing. Within the cohort, 62 patients received contrast enhanced ultrasound-guided injection of hemostatic agents and the rest received surgical treatments. RESULTS: The injury severity score was lower in the hemostatic agent treatment group than surgical treatment group (p<0.05), but Glasgow coma scale scores did not reach statistical significance. The patients in the surgical treatment group had significantly higher hospital fees than those in the hemostatic treatment group (p<0.05), although the length of hospitalization did not significantly differ between two groups. Safety outcome variables pre- and post-treatment remained within normal limits in both groups. CONCLUSIONS: Hemostatic agents were more cost-effective than surgery to treat patients with liver, spleen and kidney trauma. However, given the limited sample size, subsequent studies drawing upon larger populations from multiple medical centers are necessary for follow-up.

Contrast-enhanced ultrasonography for assessment of tumor vascularity in hepatocellular carcinoma.

OBJECTIVE: Studies have shown that angiogenesis is a critical factor for tumor growth and metastasis in a variety of human tumors. Although various methods have been tried to assess vessels in tumors, including microvessel density (MVD), assessment of tumor vessels by radiologic techniques is not well established. The aim of this study was to investigate the efficacy of contrast-enhanced ultrasonography (CEUS) in determining the tumor vascularity of hepatocellular carcinoma (HCC). METHODS: Contrast-enhanced ultrasonography was done in 50 patients with HCC, which was shown histopathologically through subsequent hepatic resection. A contrast pulse sequencing technique and quantitative auto-tracking contrast quantification software were used to analyze the peak intensity (PI) of HCC. Immunohistochemistry was performed to evaluate the level of MVD in HCC. Then the relationship between PI and the level of MVD was analyzed. RESULTS: The mean PIs of HCC and peripheral tissue +/- SD were 135.19 +/- 28.16 and 72.91 +/- 19.22 dB, respectively. The MVDs of HCC and peripheral tissue were 43.44 +/- 12.22 and 17.14 +/- 9.18, respectively. The values of PI and MVD of HCC were significantly higher than those of peripheral tissue. A significant correlation was found between PI and MVD in HCC tissues (P < .05). CONCLUSIONS: The PI in CEUS could reflect the MVD in HCC. Therefore, quantification of CEUS seems to be helpful for assessment of tumor vascularity in HCC.