[Usefulness of contrast-enhanced ultrasonography in daily clinical practice: a multicenter study in Spain]. / Utilidad de la ecografía con contraste en la práctica clínica diaria. Estudio multicéntrico español CEUS.

OBJECTIVES: We aimed to determine whether the use of ultrasonographic contrast agents improves the diagnostic performance of ultrasonography (US). MATERIAL AND METHODS: We carried out a prospective multicenter study in 42 hospitals. We included 1786 patients with inconclusive US; 84.9% of the inconclusive studies were abdominal US (including studies of the liver, kidneys, spleen, and other sites), 6.2% were studies of the peripheral vessels, 4.3% were breast studies, and 4.6% were other studies. We evaluated the type of contrast-enhanced US (color Doppler or contrast-specific method), type of contrast agent, dose and number of doses, and type of administration (bolus or infusion). We evaluated whether the findings at contrast-enhanced US improved the diagnostic performance of unenhanced US and whether they enabled a conclusive diagnosis to be reached. RESULTS: The contrast agent SonoVue was used in 99.9% of the studies; a single dose of contrast agent was used in 84.8%, and the contrast agent was administered in bolus in 98.5%. Contrast-enhanced US improved the diagnostic performance in 91.6% of cases and enabled the conclusive diagnosis in 69.2%. The best diagnostic performance was obtained in the supraaortic trunks, where a definitive diagnosis was reached in 95.4% of cases, followed by the abdominal area, with a conclusive diagnosis in 72.6% of cases. CONCLUSIONS: The use of contrast-enhanced US significantly improved the diagnostic performance of US and enabled a conclusive diagnosis in most cases.

Rotura espontánea en bazo normal. A propósito de un caso / Spontaneous rupture in a normal spleen. A case report

Presentamos un paciente de 47 años con hemorragia digestiva alta que a las 48 horas del ingreso presentó un brusco dolor en flanco izquierdo sugestivo de cólico nefrítico. El estudio ecográfico reveló la presencia de un hematoma esplénico subcapsular y líquido libre intraperitoneal. La cirugía demostró rotura subcapsular del bazo y sangre libre intraperitoneal, siendo el bazo normal. El examen anatomopatológico confirmó que se trataba de un parénquima normal. Se destacan los hallazgos ecográficos de dicha entidad así como las causas conocidas relacionadas con la rotura espontánea del bazo (AU)