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New Scan For Kids: Contrast-Enhanced US

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Contrast-enhanced ultrasound (CEUS) can improve the diagnosis of many conditions in children without exposing them to ionizing radiation or sedation, according to a German radiologist.

Martin Stenzel, Dr. med., is a pediatric radiologist at the University Hospital in Jena, Germany. He reported no adverse effects after using CEUS to image about 50 pediatric patients at his hospital. He presented his findings earlier this year at the European Symposium on Ultrasound Contrast Imaging in Rotterdam, Netherlands.

Patient movement doesn’t matter with CEUS, which is a big advantage in imaging wiggly children. As Dr. Stenzel, quoted in an International Contrast Ultrasound Society news release, said at the symposium:

This avoids the need for sedating children prior to imaging.

Contrast-enhanced ultrasound involves injecting microbubbles into the bloodstream. The microbubbles show up strongly on ultrasound scans, clearly depicting blood flow. They dissipate safely within a few minutes.

In the United States, CEUS is used mostly for cardiac imaging. In other countries, radiologists employ it to look at other organs, including the heart, liver, brain, digestive tract, and kidneys—but not with children. Dr. Stenzel noted that ultrasound contrast agents have been approved for adult patients only. Their use in children is off-label and requires informed consent. However, Dr. Stenzel said:

Our experience shows that this technology works in children as well as adults.

He said he and his colleagues have performed CEUS on patients as young as 2. Its uses, he said, include:

  • Differentiating between a benign cyst and a perfused tumor
  • Assessing kidney infections
  • Evaluating an organ’s blood flow
  • Detecting internal abdominal injuries

Dr. Stenzel said CEUS for children is safer and less expensive than alternatives such as CT and nuclear imaging.

“It is especially important to avoid subjecting children to diagnostic tests that use ionizing radiation because children have many years to live, and the risk of cancer is cumulative,” he said. “In addition, we do not know how ionizing radiation may affect future reproductive capacity or the impact it may have on their unborn children.”

He called for additional clinical trials to validate the pediatric use of CEUS.

Related seminar: Pediatric Radiology—Clinical and Radiology Perspectives

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