Diagnosis of urinary bladder rupture using ultrasound contrast cystography: in vitro model and two case-history reports

Because urinary bladder rupture can be life threatening, a simple, safe technique for evaluating patients is desirable. Current diagnostic protocols involve radiographic imaging, but ultrasound-based contrast techniques have not been methodically evaluated in veterinary patients with urologic trauma. Ultrasound contrast cystography (contrast cystosonography) involves infusion of microbubbled saline solution through a urinary catheter. It was performed in an in vitro model and in 2 dogs with naturally occurring urinary bladder rupture. A positive result consisted of visualizing microbubbles sonographically in fluid surrounding the bladder immediately after infusion of contrast into the urinary catheter. A positive result was obtained both in the in vitro model and in the 2 dogs, with radiographic and surgical confirmation of naturally occurring intraperitoneal urinary bladder rupture in the dogs. Based on the results of this study, ultrasound contrast cystography appears to be more sensitive than two-dimensional (2D) abdominal sonography for detecting naturally occurring urinary bladder rupture in dogs.