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. 2014 Dec;14(59):447-53.
doi: 10.15557/JoU.2014.0048. Epub 2014 Dec 30.

Why consider contrast-enhanced ultrasound (ce-US) in children?: Editorial comment on: M.M. Woźniak, A. Pawelec, A.P. Wieczorek, M.M. Zajączkowska, H. Borzęcka and P. Nachulewicz 2D/3D/4D contrast-enhanced voiding urosnography in the diagnosis and monitoring of treatment of vesicoureteral reflux in children - can it replace voiding cystourethrography?

Michael Riccabona  1
Affiliations

Why consider contrast-enhanced ultrasound (ce-US) in children?: Editorial comment on: M.M. Woźniak, A. Pawelec, A.P. Wieczorek, M.M. Zajączkowska, H. Borzęcka and P. Nachulewicz 2D/3D/4D contrast-enhanced voiding urosnography in the diagnosis and monitoring of treatment of vesicoureteral reflux in children - can it replace voiding cystourethrography?

Michael Riccabona. J Ultrason. 2014 Dec.
No abstract available

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Figures

Fig. 1
Fig. 1
Ce-VUS for detection of VUR. Serial images demonstrate the contrast reflux into the distal ureter in a oblique section (A) – where a second ureter also seems to be present and refluxing (equalling low pressure VUR of mild degree during filling), one contrast filled mid ureter portion (B), and the dynamic contrast reflux into the renal collecting system (C), with increasing dilatation during voiding (D) indicating additional dilating high grade and high pressure VUR. Also note the duplication of the collecting system in C and D
Fig. 2
Fig. 2
Ce-VUS – urethra assessment during voiding using a perineal approach. At the end of ce-VUS, the bladder is emptied and the urethra is visualised from a perineal approach. Dual image technique: left – contrast dedicated image, right – orienting grey scale b-mode image
Fig. 3
Fig. 3
Intravenous ce-US (CEUS) of the liver in a treated and already shrunken, partially calicafied liver haemangiendothelioma (A) with no central but little peripheral enhancement in early phases (B, dual image technique), but some residual peripheral slightly nodular enhancement on late scans (C, between + … + ). Additionally for demonstration of CEUS images and effects: normal and homogenuous enhancement of spleen (D) and gas bubbles in the liver (similar to portal pneumatosis) as known to happen with ce-US, when bowel is withing the insonated field (E) after the ce-US investigation
Fig. 4
Fig. 4
US demonstrates also non-contrasted structures, e.g. non-refluxing megaureter (U) behind the contrast filled urinary bladder in a axial view (A), or the regionally dysplastic renal parenchyma in the respective hydronephrotic kidney without any refluxed contrast in the dilated collecting system – proving absence of VUR (longitudinal section) (B)
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