Potential value of contrast-enhanced gray-scale ultrasonography in diagnosis of acute muscle injury--preliminary results.

BACKGROUND: Ultrasonography performed shortly after a direct or indirect muscle trauma may be confusing. The extent of a muscular tear can be difficult to assess because of oedema, intramuscular haematomas and red infarct. The aim of this study was to find out if it is possible to assess the extent of muscular lesions shortly (6 to 48 hours) after a trauma with improved accuracy using contrast-enhanced gray-scale ultrasonography. MATERIALS AND METHODS: Ultrasonograp[hic examinations were carried out in 7 male football players 8 to 48 hours following a direct (4) and indirect (3) trauma, and one female dancer with an indirect muscle trauma. Standard B-mode US examinations and gray-scale contrast-enhanced US after administration of Sonovue (Altana Pharma, Konstanz, Germany) were performed in all patients to evaluate the margins and size of the posttraumatic lesions. In contrast-enhanced studies, the size of the structural lesion in the muscle and space that might correspond to the muscle tear were measured. RESULTS: In all 8 cases, the borders of the muscular lesions were better delineated following administration of the contrast agent as a poorly and irregularly enhanced or non-enhancing areas. In 3 cases of direct and 2 cases of indirect trauma, the lesions were bigger in the contrast-enhanced study, and in one case of direct trauma and 2 indirect lesions, they were smaller following contrast-enhancement. CONCLUSION: These preliminary results indicate that gray-scale contrast-enhanced US of muscle can be helpful in the assessment of the extent of muscular trauma in dubious cases during the early post-injury period.