Chronologic echogenicity changes and histologic correlates in experimental blood clots a serial sonographic study

Objectives-We performed this study to identify echogenicity changes in clots and their correlations with histologic characteristics over time Methods-B-mode sonography was performed at 2, 6, 24, and 48 hours after clot formation in venous blood from healthy donors. Analysis of echogenicity was performed by grayscale median measurement with normalization. We classified clots into 3 groups: dense, intermediate, and loose according to red blood cell (RBC) density on hematoxylineosin staining Results-Statistically significant chronologic changes in the grayscale median measurements were shown, with a trough at 6 hours and a peak at 24 hours (mean ± SD: 2 hours, 46.8 ± 4.1; 6 hours, 32.2 ± 13.1; 24 hours, 55.4 ± 9.9; 48 hours, 49.0 ± 13.9; P = .027). The grayscale median value was higher in dense RBC clots and lower in loose RBC clots (dense, 61.0 ± 10.6; intermediate, 49.4 ± 13.1; loose, 34.0 ± 12.1; P< .0353) Conclusions-Sonography using the grayscale median showed chronologic echogenicity changes in clots over a 48-hour period, and the grayscale median correlated with RBC density.