Upper gastrointestinal tract perforation assessed by contrast-enhanced ultrasonography after oral Sonazoid administration in a stomach leakage mouse model

Purpose: The purpose of this study was to elucidate whether contrast-enhanced ultrasonography (CEUS) can visualize orally administered Sonazoid leaking into the peritoneal cavity in a postoperative stomach leakage mouse model. Methods: Adult female mice (n=33, 9-10 weeks old) were used. Preoperative CEUS was performed after delivering Sonazoid via intraperitoneal injection and the per oral route. A gastric leakage model was then generated by making a surgical incision of about 0.5 cm at the stomach wall, and CEUS with per oral Sonazoid administration was performed. A region of interest was drawn on the CEUS images and the signal intensity was quantitatively measured. Statistical analysis was performed using a mixed model to compare the signal intensity sampled from the pre-contrast images with those of the post-contrast images obtained at different time points. Results: CEUS after Sonazoid intraperitoneal injection in normal mice and after oral administration in mice with gastric perforation visualized the contrast medium spreading within the liver interlobar fissures continuous to the peritoneal cavity. A quantitative analysis showed that in the mice with gastric perforation, the orally delivered Sonazoid leaking into the peritoneal cavity induced a statistically significant (P<0.05) increase in signal intensity in all CEUS images obtained 10 seconds or longer after contrast delivery. However, enhancement was not observed before gastric perforation surgery (P=0.167). Conclusion: CEUS with oral Sonazoid administration efficiently visualized the contrast medium spreading within the peritoneal cavity in a postoperative stomach leakage mouse model.