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Slovenska pediatrija 2017; 24: 152-161

https://doi.org/

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Review article

THE ROLE OF INTRAVENOUS CONTRAST-ENHANCED ULTRASONOGRAPHY IN CHILDREN

D. Ključevšek
Služba za radiologijo, Pediatrična klinika, Univerzitetni klinični center Ljubljana, Ljubljana, Slovenija

Abstract

The development of ultrasound contrast agents (UCAs) has led to significant progress in US diagnostics in adults and also in children. In the USA, UCAs are registered for intravenous use for the assessment of focal changes in the liver and for use in the urinary bladder for the diagnosis of vesico-ureteral reflux. Although UCAs are not registered in Europe for children younger than 18 years, the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) encourages the implementation of contrast-enhanced ultrasound (CEUS) examinations in this age group as it is a child-friendly method that offers significant diagnostic improvement. It is easily performed in children because of their smaller body size and a more favourable tissue composition compared to adults. At the same time, this is a radiation and sedation-free method. All published studies have shown a high safety profile of UCAs with the lowest rate of side effects compared to iodine or paramagnetic CAs. CEUS is usually a problem- solving method and there is no need for further, more invasive examinations. Intravesical application of UCAs has become the standard method in paediatric urodiagnostic algorithms. Intravenous application of UCAs has justified its use in the evaluation of different focal lesions, in post-traumatic evaluations of the liver and spleen, and in evaluations of tissue perfusion. In this review, the role of CEUS and its clinical applications in childhood are discussed. At the same time, our experience in this field of radiology is presented.

Key words: Key words: contrast-enhanced ultrasonography, ultrasound contrast agent, intravenous, children.