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Diagnosis of congenital and acquired focal lesions in the neck, abdomen, and pelvis with contrast-enhanced ultrasound: a pictorial essay

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Abstract

Contrast-enhanced ultrasound (CEUS) is a versatile imaging modality that improves the diagnostic potential of conventional ultrasound. It allows for portable imaging at the bedside. In this paper, we illustrate how CEUS can be used in evaluating several focal lesions in the pediatric population, including liver hemangioma, telangiectasias, splenic hamartomas, and bladder lesions. We describe the ultrasound findings and contrast enhancement patterns associated with these lesions. Findings are correlated with MRI, CT, and/or pathology when available. This paper demonstrates the value of CEUS in improving characterization of many focal lesions in the pediatric population.

Conclusion: CEUS is a valuable bedside technique for use in the pediatric population to evaluate focal lesions in various organs, and will allow for safe, more efficient diagnostic imaging.

What is Known:

CEUS offers many advantages over CT and MRI and is underutilized in the United States.

It is only FDA approved for vesicoureteral reflux and liver in the pediatric population. However, off label uses are well described.

What is New:

This pictorial essay describes ultrasound findings and contrast enhancement patterns associated with liver hemangioma, liver telangiectasia, splenic hamartoma, hemorrhagic ovarian cyst, urachal remnant, spinning top urethras, and kaposiform hemangioendothelioma.

We demonstrate the utility of CEUS in expanding the diagnostic potential of conventional ultrasound.

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Abbreviations

CEUS:

Contrast-enhanced ultrasound

CT:

Computed tomography

FDA:

Food and Drug Administration

MRI:

Magnetic resonance imaging

US:

Ultrasound

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Funding

There was no source of funding for this paper.

Author information

Authors and Affiliations

Authors

Contributions

Matthew Thimm: Project conception and design, drafting, revising, and final approval of manuscript.

Daniel Rhee: Primary physician who referred case and was involved in writing the clinic history, revising, and final approval of manuscript.

Clifford Takemoto: Primary physician who referred case and was involved in writing the clinic history, revising, and final approval of manuscript.

Wikrom Karnsakul: Primary physician who referred case and was involved in writing the clinic history, revising, and final approval of manuscript.

Carmen Cuffari: Primary physician who referred case and was involved in writing the clinic history, revising, and final approval of manuscript.

Anthony Guerrerio: Primary physician who referred case and was involved in writing the clinic history, revising, and final approval of manuscript.

Alejandro Garcia: Primary physician who referred case and was involved in writing the clinic history, revising, and final approval of manuscript.

John Gearhart: Primary physician who referred case and was involved in writing the clinic history, revising, and final approval of manuscript.

Thierry Huisman: Revising and final approval of manuscript.

Misun Hwang: Responsible for project conception and design, data acquisition and analysis, revising, and final approval of manuscript.

Corresponding author

Correspondence to Misun Hwang.

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Conflict of interest

The authors declare no conflict of interest.

Informed consent

Informed consent was obtained from all subjects. This study was approved by the Institutional Review Board (IRB).

Ethical standards

This study was approved by the Institutional Review Board (IRB) and was performed with the ethical standards laid down in the 1964 Declaration of Helsinki. Informed consent was obtained from all subjects.

Additional information

Communicated by Piet Leroy

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Thimm, M.A., Rhee, D., Takemoto, C.M. et al. Diagnosis of congenital and acquired focal lesions in the neck, abdomen, and pelvis with contrast-enhanced ultrasound: a pictorial essay. Eur J Pediatr 177, 1459–1470 (2018). https://doi.org/10.1007/s00431-018-3197-8

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  • DOI: https://doi.org/10.1007/s00431-018-3197-8

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