Potential causes of insufficient bladder contrast opacification and premature microbubble destruction during contrast‐enhanced voiding urosonography in children

Abstract

Contrast‐enhanced voiding urosonography (ceVUS) has been recognized as a child‐friendly examination with high diagnostic accuracy for vesicoureteric reflux detection. A single bolus and the infusion techniques of ceVUS are described. Insufficient bladder contrast opacification during the filling phase and premature destruction of SonoVue microbubbles might occur. Data regarding SonoVue's features, doses, bladder contrast opacification, US bladder parameters, urine catheter, antibiotic prophylaxis, and childrens behaviors were collected to discover the possible causes of the contrast vanishing observed during bladder filling in 10% of examinations and in the later phase of ceVUS in 5% of examinations. An updated ceVUS examination protocol is suggested.

Value of contrast-enhanced sonography in the diagnosis of vesicoureteral reflux

“…There is currently only insufficient literature regarding the periprocedural application of an antibiotic for ceVUS. Some individual studies were performed without the administration of antibiotics [38] or with a single administration on the day of the examination [39]. In comparison, administration of an antibiotic the day before, the day of, and the day after VCUG is recommended [40].…”

“…Zur periprozeduralen Anwendung eines Antibiotikums gibt es für die ceVUS bislang keine ausreichende Literatur. Einzelstudien wurden teilweise ohne Antibiotikagabe durchgeführt [38] oder mit einer Einmalgabe am Untersuchungstag [39]. Im Vergleich hierzu wird für die Durchführung der VCUG eine Antibiotikagabe am Vortag, am Untersuchungstag und am Folgetag empfohlen [40].…”