Echo-Enhanced Color Doppler Cystosonography of Vesicoureteral Reflux in Children. Improvement by stimulated acoustic emission

Abstract

Levovist ee-CS is feasible in the pediatric bladder. It enables reliable visualization of VUR in the renal collecting system. Burst-CS improves visualization of contrast reflux, particularly in non-dilative or minimally dilative VUR, which is sometimes difficult to depict with conventional ee-CS.

Correction of vesicoureteral reflux: where do we stand?

“…Echo-enhanced colour Doppler sonography using Levovist was compared with conventional VCUG on the same day in 30 children aged 0-9 years with suspected VUR. The echoenhanced colour Doppler sonography detected VUR in four systems not seen by VCUG and missed low-degree VUR in two cases seen by the VCUG [18]. Uhl et al [19] had similar results in 24 children with a mean age of 3.5 years.…”

A comparison of echo‐enhanced voiding urosonography with X‐ray voiding cystourethrography in the first year of life

“…It is, therefore, not surprising that in spite of better sensitivity and lack of radiation that can be achieved by VUS, VCUG is still the most widely accepted diagnostic test for VUR detection in this age group. In the last decade, however, we have witnessed remarkable technical progress in US hardware and software, the development of specific CHI techniques, and the introduction of a second‐generation US contrast agent, all of which have improved the accuracy and sensitivity of basic and contrast‐enhanced US techniques (16–22). To the best of our knowledge, there is only one dedicated report available that compared echo‐enhanced VUS with VCUG in the neonatal period (aged 28–90 days, mean 48 days); conventional US techniques and the first generation echo‐contrast agent Levovist were compared to VCUG with a sensitivity of 64% and a specificity of 100%, respectively.…”

Guidelines and Good Clinical Practice Recommendations for Contrast Enhanced Ultrasound (CEUS) - Update 2008

“…When using Levovist ® , fundamental US scanning may suffice for the diagnosis of reflux. The additional use of colour Doppler can increase the sensitivity of reflux detection [108,112,113]. Harmonic imaging has proved to be of considerable advantage in VUS as it markedly increases the conspicuity of the microbubbles and the detection rate of reflux [114 -116].…”