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Erschienen in:
12.04.2017 | Classics in Abdominal Imaging
The patent track sign
Erschienen in: Abdominal Radiology | Ausgabe 10/2017
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The patent track sign is a recently described radiological finding on color Doppler ultrasound, which is useful in the detection of internal bleeding in solid organs such as liver and kidney, following percutaneous transparenchymal interventional procedures [1] (Fig. 1). It refers to the immediate detection of a linear trail of color flow along the puncture track, extending toward the surface of the organ [2]. This can occur following any diagnostic or therapeutic procedure and is due to a patent communication between an intraparenchymal vessel and the surface of the organ, via the track. The patent track usually resolves spontaneously, or following ultrasound-guided compression of the bleeding site; however, the persistence of color Doppler flow within the track beyond 5 min strongly predicts the occurrence of subsequent hemodynamically significant hemorrhage [1].
Fig. 1
Patent track sign in a 73-year-old man following percutaneous transhepatic right portal vein embolization. A Doppler sonogram of the liver, with the region of interest over the recent percutaneous puncture area demonstrates linear color flow along the puncture track representing the patent track sign. B Spectral waveform analysis of the patent track, at 5 min, demonstrates persistence of pulsatile arterial flow. New small perihepatic hematoma is also seen (arrow). C The coronal section of the CT scan in the venous phase, acquired within 30 min, demonstrates high density fluid (Avg. of 57 HU) in the perihepatic space, extending into the right paracolic gutter (star), suggestive of significant intraperitoneal hemorrhage. The arterial and delayed phases (not shown) did not demonstrate active contrast extravasation or pooling, suggesting spontaneous cessation of the bleeding. Scattered intrahepatic radiodensities are from the right portal vein embolization
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