Literature DB >> 27098352

CT characteristics of Morel-Lavallée lesions: an under-recognized but significant finding in acute trauma imaging.

Gavin A McKenzie1, Blake D Niederhauser1, Mark S Collins1, Benjamin M Howe2.   

Abstract

OBJECTIVE: To highlight the significance and imaging characteristics of Morel-Lavallée (ML) lesions, which have been well characterized on MRI, but are potentially under-recognized on CT.
MATERIALS AND METHODS: Twenty-eight Morel-Lavallée lesions were identified in 18 patients and were all clinically or surgically confirmed. Lesions were grouped into acute (<3 days), subacute (3-30 days), and chronic (>30 days) at the time of CT imaging. Charts were reviewed to gather patient characteristics, injury patterns, radiologist interpretation, treatment, and outcomes.
RESULTS: Sixteen male and 2 female patients with a mean age of 50 years (range 19-80) at the date of their initial evaluation were identified. All patients had significant trauma that accounted for 28 ML lesions, all of which were in a characteristic subcutaneous location overlying the muscular fascial plane. Lesions on CT went through an evolution from hyperdense, poorly or moderately marginated without a pseudocapsule to being hypodense, with internal fat globules or septations and well marginated with a complete enhancing pseudocapsule. Only 1 (4 %) of the ML lesions was suggested and 7 (25 %) lesions were not commented on at all by the interpreting radiologist.
CONCLUSION: Morel-Lavallée lesions are post-traumatic closed, internal, soft-tissue, degloving lesions that are potentially underrecognized on CT. Most acute ML lesions are nonspecific, resembling simple hematomas or contusions. ML lesions evolve as they age with subacute and chronic lesions demonstrating the known features described on MR imaging that should allow for an accurate imaging diagnosis.

Entities:  

Keywords:  Chronic hematoma; Closed degloving injury; Floating fat; Morel-Lavallée

Mesh:

Year:  2016        PMID: 27098352     DOI: 10.1007/s00256-016-2374-y

Source DB:  PubMed          Journal:  Skeletal Radiol        ISSN: 0364-2348            Impact factor:   2.199


  15 in total

1.  MRI of a Morel-Lavellée lesion.

Authors:  Bruce Curtiss Gilbert; Liem T Bui-Mansfield; Schuyler Dejong
Journal:  AJR Am J Roentgenol       Date:  2004-05       Impact factor: 3.959

2.  Early diagnosis of a Morel-Lavallee lesion using three-dimensional computed tomography reconstructions: a case report.

Authors:  Robert Nathaniel Reddix; Eben Carroll; Lawrence Xavier Webb
Journal:  J Trauma       Date:  2009-08

Review 3.  The Morel-Lavallée lesion: pathophysiology, clinical presentation, imaging features, and treatment options.

Authors:  Iris Bonilla-Yoon; Sulabha Masih; Dakshesh B Patel; Eric A White; Benjamin D Levine; Kira Chow; Christopher J Gottsegen; George R Matcuk
Journal:  Emerg Radiol       Date:  2013-08-16

4.  The Mayo Clinic experience with Morel-Lavallée lesions: establishment of a practice management guideline.

Authors:  Terry P Nickerson; Martin D Zielinski; Donald H Jenkins; Henry J Schiller
Journal:  J Trauma Acute Care Surg       Date:  2014-02       Impact factor: 3.313

Review 5.  Surgical management of soft tissue lesions associated with pelvic ring injury.

Authors:  S A Kottmeier; S C Wilson; C T Born; G A Hanks; W M Iannacone; W G DeLong
Journal:  Clin Orthop Relat Res       Date:  1996-08       Impact factor: 4.176

6.  The blood supply of thigh skin.

Authors:  G C Cormack; B G Lamberty
Journal:  Plast Reconstr Surg       Date:  1985-03       Impact factor: 4.730

7.  Organizing hematoma of the thigh. Multiple imaging techniques.

Authors:  R E Lovern; D A Bosse; M F Hartshorne; J M Bauman; J L Billingsley; B F Byrd; G D Momii; L A Crooks
Journal:  Clin Nucl Med       Date:  1987-08       Impact factor: 7.794

Review 8.  Morel-Lavallée lesion: review with emphasis on MR imaging.

Authors:  José M Mellado; Jenny T Bencardino
Journal:  Magn Reson Imaging Clin N Am       Date:  2005-11       Impact factor: 2.266

9.  Morel-Lavallée effusions in the thigh.

Authors:  J A Parra; M A Fernandez; B Encinas; M Rico
Journal:  Skeletal Radiol       Date:  1997-04       Impact factor: 2.199

10.  Sonography of Morel-Lavallee lesions.

Authors:  Colleen Neal; Jon A Jacobson; Catherine Brandon; Monica Kalume-Brigido; Yoav Morag; Gandikota Girish
Journal:  J Ultrasound Med       Date:  2008-07       Impact factor: 2.153

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  8 in total

1.  Can a Morel-Lavallée lesion be misdiagnosed as a mass like lesion?

Authors:  Yoon Jae Lee; Jun Hyeok Kim; Ji Young Kim; Hyun Ho Han
Journal:  Int Wound J       Date:  2017-07-25       Impact factor: 3.315

2.  Morel-Lavallée lesion of the proximal tibia in an obese patient after low-energy trauma.

Authors:  Dirk Pieter Hogerzeil; Joris Jansen
Journal:  BMJ Case Rep       Date:  2017-06-13

Review 3.  Morel-Lavallee Lesions-Review of Pathophysiology, Clinical Findings, Imaging Findings and Management.

Authors:  Sreelatha Diviti; Nishant Gupta; Kusum Hooda; Komal Sharma; Lawrence Lo
Journal:  J Clin Diagn Res       Date:  2017-04-01

4.  CT incidence of Morel-Lavallee lesions in patients with pelvic fractures: a 4-year experience at a level 1 trauma center.

Authors:  Nicholas M Beckmann; Chunyan Cai
Journal:  Emerg Radiol       Date:  2016-08-16

5.  A Rare Case of Hemorrhagic Shock: Morel-Lavallée Lesion.

Authors:  Lieke Claassen; Myriam Anna Franssen; Erik Robert de Loos
Journal:  Clin Pract Cases Emerg Med       Date:  2019-10-21

Review 6.  Practical Review of the Comprehensive Management of Morel-Lavallée Lesions.

Authors:  Bianca J Molina; Erika N Ghazoul; Jeffrey E Janis
Journal:  Plast Reconstr Surg Glob Open       Date:  2021-10-07

7.  Surgical Treatment of a Chronic Morel-Lavallée Lesion: A Case Report.

Authors:  Megan Mooney; Marshall Gillette; Drew Kostiuk; Maged Hanna; Nabil Ebraheim
Journal:  J Orthop Case Rep       Date:  2020

8.  A rare case of severe third degree friction burns and large Morel-Lavallee lesion of the abdominal wall.

Authors:  Darnell J Brown; Kuo Jung G Lu; Kristina Chang; Jennifer Levin; John T Schulz; Jeremy Goverman
Journal:  Burns Trauma       Date:  2018-03-06
  8 in total

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