Abstract
Brain contrast-enhanced ultrasound offers insights into the brain beyond the anatomic information offered by conventional grayscale ultrasound. In infants, the open fontanelles serve as acoustic windows. In children, whose fontanelles are closed, the temporal bone serves as the ideal acoustic window due to its relatively smaller thickness than the other skull bones. Diagnosis of common neurologic diseases such as stroke, hemorrhage, and hydrocephalus has been performed using the technique. Transtemporal ultrasound and contrast-enhanced ultrasound, however, are rarely used in children due to the prevalent notion that the limited acoustic penetrance degrades diagnostic quality. This review seeks to provide guidelines for the use of transtemporal brain contrast-enhanced ultrasound in children.
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Acknowledgements
The authors would like to acknowledge Lydia Sheldon, M.S. Ed., medical writer at Children’s Hospital of Philadelphia, Department of Radiology, for editing this manuscript and Brittany Bennett, M.A., medical illustrator at Children’s Hospital of Philadelphia, Department of Radiology, for providing Fig. 1.
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Videoclip. A 1-year-old boy with normal brain underwent transtemporal CEUS. This clip represents the midbrain and the perimesencephalic region in the axial plane during the wash-in phase (first 30 seconds after contrast injection). There is avid enhancement of the perimesencephalic vessels; a grayscale clip is shown on the right for comparison. (MP4 5260 KB)
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Hwang, M., Tierradentro-Garcia, L.O. A concise guide to transtemporal contrast-enhanced ultrasound in children. J Ultrasound 26, 229–237 (2023). https://doi.org/10.1007/s40477-022-00690-3
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DOI: https://doi.org/10.1007/s40477-022-00690-3