Purpose: Contrast-enhanced ultrasonography (CEUS) is a safe and promising ultrasound modality in adults. Due to off-label use, there is only limited experience in children. Main indications, results, safety and special paediatric aspects are presented.
Patients and Methods: In the past five years, a total of 160 iv. CEUS investigations were performed in 126 children (62 females, 64 males) at the Paediatric Ultrasonography Unit at Hannover Medical School, Germany. A second follow-up was performed in 25 patients, a third in 7 and a fourth in 2 patients. Mean age was 9.0 years (range 0.1 – 18.2 years). Written informed consent was obtained from the parents/caregivers. Dosages of 0.3 -2 ml SonoVue® were used. None of the infants or children required sedation. More than a third of patients (32%) had childhood oncological diseases. 10% of children had CEUS-indications after solid organ transplantation.
Results: The most frequent indications were focal lesions in the liver, kidneys or spleen, trauma, solid tumours of unclear origin and perfusion disorders. In most CEUS investigations (125/160) only a single organ was investigated. In 25 investigations a second, and in 10 a third organ was examined. The most frequently investigated organs were the liver including liver transplants (n= 123), kidneys including renal transplants (n=29), spleen (n=25), gut (n=9) and others (small parts, biliary system, adrenals, pancreas, pleura, vessels). The rate of pathological results was 132/160 (83%), normal 26/160 and inconclusive 2/160. 33/160 (21%) investigations were performed mobile on the intensive care unit (ICU). In 160 investigations only a single possible allergic side-effect occurred in a 16 year old female.
Conclusion: Intravenous CEUS investigations in children were safe and revealed a high rate of results relevant for the diagnosis and further management of the child. Additional advantages of CEUS were avoidance of general anaesthesia in infants, the mobile use on ICU and lower costs compared to MRI/CT.
