Diagnosis of an actively bleeding brachial artery hematoma by contrast-enhanced ultrasound: A case report

Figure 1 Findings of gray-scale ultrasound. A and B: The gray-scale ultrasound revealed a mainly hypoechoic mass of approximately 11.2 cm × 3.5 cm × 3.4 cm beside the left brachial artery (arrow), with a hyperechoic area of approximately 3.3 cm × 2.3 cm and an anechoic area of about 0.7 cm × 0.3 cm.

Figure 2 Findings of color Doppler ultrasound. A: The color Doppler ultrasound revealed blood flow signals of arteries branching into the hematoma (arrow); B: A narrow band of blood flow was detected in the hypoechoic area with a three-phase wave arterial flow spectrum.

Figure 3 Findings of contrast-enhanced ultrasound. A: Microbubbles were first detected at 13 s emerging from the brachial artery into the hematoma; B-D: Microbubbles diffused into the hematoma with the local surge of red blood cells; E: Microbubbles disappeared after approximately 23 s.

Figure 4 Findings of ultrasound 20 d later. After pressure bandaging treatment, the hematoma became smaller (3.1 cm × 1.7 cm) and organized.