Contrast-Enhanced Ultrasound in Children: Implementation and Key Diagnostic Applications

Squires, Judy; McCarville, M. Beth

doi:10.2214/ajr.21.25713

Cited by 30 publications

(12 citation statements)

References 94 publications

(105 reference statements)

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“…In general, the contrast is very safe to patients, with a low rate of anaphylactoid reactions compared to the other types of contrast agents ( 18 ). Although some mild adverse events have been reported with the use of a CEUS contrast agent, such as injection site pain or rash, light headache, chest discomfort, nausea, and hyperventilation ( 19 ), the ultrasound contrast is considered the safest agent among other types of contrast media, with a very low frequency of severe adverse events (0.007%–0.0086%) ( 18 , 20 ), which is lower than that of iodinated media and lower than or similar to that of gadolinium agents ( 21 , 22 ). The value of CEUS in the evaluation of several tumors and vascular disease has been proven by other studies ( 10 , 23 , 24 ), while its utilization in CBT assessment remains to be investigated.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Contrast-Enhanced Ultrasonography to Color Doppler Ultrasound in Evaluation of Carotid Body Tumors

Zhang

Shen

et al. 2022

Front. Oncol.

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ObjectiveThe objectives of this study were to prospectively 1) explore the characteristics and enhanced patterns of carotid body tumors (CBTs) at color Doppler ultrasound (CDU) and contrast-enhanced ultrasonography (CEUS) qualitatively and quantitatively and 2) compare CDU and CEUS for their morphology and vascularity signature.MethodsCDU and CEUS with Sonovue® were used to evaluate 25 CBT lesions. The comparison between these ultrasonic modalities included the size, Shamblin type, vascularity, and feeding vessels of the lesion areas. The time–intensity curve (TIC) analysis was used to obtain the dynamics of the contrast-enhancement features of CBTs.ResultsThe TIC analysis presented a fast wash-in [wash-in time: 3.00 ± 1.10 s, mean ± SD] and slow wash-out [wash-out time: 58.79 ± 24.21 s, mean ± SD] pattern in the CBT lesions, with a high area under the curve (AUC) of 669.68 ± 143.46 mm2 (mean ± SD). In comparison with CDU, CEUS was superior in identifying Shamblin type I or III CBT lesions (χ2 = 17.389, p=0.002). It detected a significant difference in the AUC between moderate and marked vascularity groups (563.33 ± 102.63 vs. 707.22 ± 138.81, t=-2.311, p=0.031.), while CDU observed no significant difference between these two groups. Although CDU was more sensitive than CEUS in detecting feeding vessels (100% vs. 88%), CEUS better visualized the origins of feeding vessels (χ2 = 9.162, p=0.010).ConclusionCEUS can better investigate the Shamblin type and vascularity of CBT lesions than CDU. CBTs displayed a fast wash-in, slow wash-out pattern with high AUC in the TIC analysis in the CEUS mode. CDU is more sensitive in detecting feeding vessels than CEUS, while CEUS can better visualize the origins of feeding vessels.

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Section: Discussionmentioning

confidence: 99%

Comparison of Contrast-Enhanced Ultrasonography to Color Doppler Ultrasound in Evaluation of Carotid Body Tumors

Zhang

Shen

et al. 2022

Front. Oncol.

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“…In recent years, CEUS has established itself as a beneficial and widely used diagnostic imaging method in many different areas, such as echocardiography, for the evaluation of vesicoureteral reflux and characterisation of liver neoplasms [ 10 ]. Due to a lack of clinical reports and safety studies, the use of CEUS for the assessment of brain pathology in children is, for now, still considered off-label [ 11 , 13 ]. Nevertheless, there has been an increasing number of reports on the use of CEUS in children for the assessment of hypoxic-ischemic injury, acute ischemic stroke, brain tumours, paediatric neurovascular diseases, epilepsy, and the confirmation of brain death [ 5 , 11 , 14 , 15 ].…”

Section: Discussionmentioning

confidence: 99%

Contrast-Enhanced Ultrasound (CEUS) as an Ancillary Imaging Test for Confirmation of Brain Death in an Infant: A Case Report

2022

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The practices for determining brain death are based on clinical criteria and vary immensely across countries. Cerebral angiography and perfusion scintigraphy are the most commonly used ancillary imaging tests for brain death confirmation in children; however, they both share similar shortcomings. Hence, contrast-enhanced ultrasound (CEUS) as a relatively inexpensive, easily accessible, and easy-to-perform technique has been proposed as an ancillary imaging test for brain death confirmation. CEUS has established itself as a favourable and widely used diagnostic imaging method in many different areas, but its application in delineating brain pathologies still necessities further validation. Herein, we present a case report of a 1-year-old polytraumatised patient in whom CEUS was applied as an ancillary imaging test for confirmation of brain death. As CEUS has not been validated as an ancillary test for brain death confirmation, the diagnosis was additionally confirmed with cerebral perfusion scintigraphy.

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“…CEUS of the spleen has shown a remarkable ability to depict benign or malignant lesions with a relative low cost and an outstanding safety profile, demonstrating higher value in comparison to B-mode US in patients with focal splenic lesions [ [3] , [4] , [15] , [16] ].…”

Section: Discussionmentioning

confidence: 99%

“…SonoVue (Bracco SpA, Milan, Italy) is the most commonly used UCAs and it contains sulphur hexafluoride gas. The addition of sodium chloride to a lyophilized powder followed by vigorous shaking results in the production of microbubbles of sulphur hexafluoride which are exhaled via the lungs with an excellent safety-profile [1] , [2] , [3] , [4] , [5] . The assessment of CEUS in spleen disease is poorly documented especially compared to liver examination.…”

Section: Introductionmentioning

confidence: 99%

Identification of secondary splenic lymphoma with contrast-enhanced ultrasound in the pediatric population. A case report

D’Auria

Ferrara

Argenziano

et al. 2022

Radiology Case Reports

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Contrast-enhanced ultrasound scan (CEUS) is the application of ultrasound contrast agents (UCAs) to traditional ultrasound. Our aim is to report the use of CEUS for a prompt assessment of a suspected secondary splenic lymphoma in a child, which, in our experience, has allowed an accurate description of the parenchymal perfusion and vascularization pattern, leading to a confident diagnosis. We suggest that CEUS will replace Magnetic resonance imaging (MRI) or Computed tomography (CT) as standard imaging option for differential diagnosis of spleen lesions in pediatric population. As a result this will lead to decreasing the overall use of ionizing radiation and reducing the time interval to a certain diagnosis.

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Contrast-Enhanced Ultrasound in Children: Implementation and Key Diagnostic Applications

Cited by 30 publications

References 94 publications

Comparison of Contrast-Enhanced Ultrasonography to Color Doppler Ultrasound in Evaluation of Carotid Body Tumors

Comparison of Contrast-Enhanced Ultrasonography to Color Doppler Ultrasound in Evaluation of Carotid Body Tumors

Contrast-Enhanced Ultrasound (CEUS) as an Ancillary Imaging Test for Confirmation of Brain Death in an Infant: A Case Report

Identification of secondary splenic lymphoma with contrast-enhanced ultrasound in the pediatric population. A case report

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