Pediatric Radiology 

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An example of a contrast enhanced ultrasound of the liver is shown, with the orange contrasted image on the left and the non-contrasted image on the right.

Contrast-Enhanced Ultrasound (CEUS)

For certain medical questions, in addition to general sonography, a special ultrasound examination is performed with contrast medium, which is applied via a vein into the bloodstream.

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Examination

Contrast-enhanced ultrasonography (also abbreviated as CEUS) can be used to more accurately assess certain findings, e.g., those obtained in previous examinations. A typical application is the further assessment of changes in the liver or kidneys.

Contrast-enhanced sonography, including preparations, takes about 30 minutes. Prior to the examination, an explanation is given regarding the indication, procedure and risks of the examination. A venous access is then placed in a vein in the arm. A small amount of contrast medium is applied via this during the examination. The contrast medium consists of gas-filled microbubbles, which then circulate through the body in the blood vessels. Ultrasound can then be used to visualize the way in which the contrast medium is distributed in the organ being examined in order to characterize pathological changes more precisely.

Preparation

Usually no special preparation of your child for the examination is necessary. However, if certain questions arise, your child should come to the appointment on an empty stomach. This will be communicated to you in advance when you make your appointment or by the referring physicians.

Mictionurosonography (MUS)

The MUS is a special form of contrast medium ultrasound that is used to clarify diseases of the urinary tract, usually when there have been abnormalities of the kidneys, ureters or urinary bladder in previous ultrasound examinations or when your child suffers from recurrent kidney or urinary tract infections. A typical question for the exam is the presence of vesicoureterorenal reflux (VUR), which is backflow of urine from the urinary bladder toward the kidneys.

In this examination, the contrast medium is applied to the urinary tract rather than to the bloodstream. At the beginning of the examination, a urinary bladder catheter is first inserted via the urethra, through which an ultrasound contrast medium is introduced. Ultrasound is then used to examine the kidneys and ureters at rest and during urination to check whether the contrast medium has entered the ureters and renal pelvises. Following the examination, the catheter is removed. A MUS usually takes about 30 minutes, including preparations.

Special preparation of your child is usually not necessary for the examination. If the examination is performed under short anesthesia, your child must appear fasting on the day of the examination; in this case, you will receive a separate preparatory consultation.