Stellenwert der kontrastmittelunterstützten Sonographie im Vergleich zur konventionellen B-Bild Sonographie in der Darstellung von Milzlazerationen bei Patienten mit traumatischen und nicht-traumatischen Milzverletzungen: eine retrospektiv deskriptive Studie

Introduction: Both US B-mode and CEUS are well established procedures when diagnosing traumatic splenic ruptures (TSR). Up to date there are no data about CEUS patterns in spontaneous splenic ruptures (SSR). It is uncertain whether SSR and TSR differ concerning clinic, B-mode and CEUS pattern as well as prognosis. Patients and Methods: Between 12/2003 and 2/2010 n=33 SSR and n=29 TSR were diagnosed in a medical universitary ultrasound center. All patients were examined with B-mode and CEUS. Clinical data, US B-mode and CEUS pattern incl. grading, and course of disease were retrospectively analysed and compared. Results: There were significant differences concerning clinical data, such as age and underlying disease . The mortality within 4 weeks was significantly higher in SSR than in TSR (p=0,001). No differences could be shown between grading of TSR and SSR neither in B-mode nor in CEUS. As expected, CEUS was significant superior to B-mode concerning the grading of splenic ruptures (p=0,01). In certain subgroups the choice of therapy was therefore influenced by CEUS. Conclusion: There are differences between SSR and TSR especially concerning clinical data (age, course and mortality). Regarding the sonographic pattern SSR and TSR show identical grading. When suspected splenic rupture, CEUS should always be performed to identify patients of risk for interventional procedures.