CEUS诊断及动态随访经皮肾穿刺后活动性出血

目的 探讨CEUS诊断及动态随访经皮肾穿刺后活动性出血的价值。方法 收集在我科接受经皮肾穿刺、经DSA检查及增强CT检查证实的肾周血肿患者42例,接受CEUS检查,以血肿内造影剂呈点条状不均匀、低增强充填为CEUS诊断活动性出血征象。对有活动性出血的病例于首次CEUS检查后5~7日后再次复查CEUS,检测血肿范围和活动性出血情况。结果 42例肾周血肿患者常规超声均未探及血肿内彩色血流信号。进一步CEUS示33例为单纯肾血肿,9例为肾血肿伴活动性出血,保守治疗后CEUS随访,其中6例活动性出血减少,DSA检查未发现明显出血灶,3例活动性出血增多,血肿增大,经介入治疗后出血停止。结论 CEUS能敏感捕捉到经皮肾穿刺后活动性出血征象。利用CEUS随访活动性出血的动态改变,可为进一步选择治疗方案提供依据。

CEUS in diagnosis and follow-up of renal hemorrhage following percutaneous renal biopsy

Objective To discuss the value of CEUS in diagnosis and follow-up in patients with hemorrhage following percutaneous renal biopsy(PRB). Methods Totally 42 patients with perirenal hematoma following PRB confirmed by enhanced CT or DSA underwent CEUS. The hemorrhage was diagnosed using CEUS when the contrast agents was in the shape of spotty and strip within the hematoma and the enhancement intensity was lower than renal parenchyma. All patients with hemorrhage underwent CEUS again after 5 to 7 days to reevaluate the change of hemorrhage. Results Conventional ultrasound was not found color flow signals in perirenal hematoma of 42 patients, but CEUS found isolated hematoma in 33 patients and hematoma with hemorrhage in 9 patients. After conservative treatment, hemorrhage were controlled in 6 patients and hemorrhage progressed in 3 patients. After interventional treatment, bleeding stopped. Conclusion CEUS has great capacity in detecting the hemorrhage following PRB. CEUS following-up active bleeding could provide valuable information in regard to the necessity of interventional treatment.