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Contrast-enhanced ultrasound in pediatric interventional radiology

  • Contrast-enhanced ultrasound (CEUS) in children
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Abstract

There is growing interest in the use of contrast-enhanced ultrasound (CEUS) in diagnostic and interventional radiology. CEUS applications in interventional radiology are performed with intravascular or intracavitary administration of microbubble-based US contrast agents to allow for real-time evaluation of their distribution within the vascular bed or in body cavities, respectively, providing additional information beyond gray-scale US alone. The most common interventional-radiology-related CEUS applications in children have been extrapolated from those in adults, and they include the use of CEUS to guide lesion biopsy and to confirm drain placement in pleural effusions and intra-abdominal fluid collections. Other applications are emerging in interventional radiology for use in adults and children, including CEUS to optimize sclerotherapy of vascular malformations, to guide arthrography, and for lymphatic interventions. In this review article we present a wide range of interventional-radiology-related CEUS applications, emphasizing the current and potential uses in children. We highlight the technical parameters of the CEUS examination and discuss the main imaging findings.

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Acknowledgments

Figure 8 courtesy of Yoav Dori, MD, Children’s Hospital of Philadelphia.

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Authors and Affiliations

  1. Department of Radiology, Children’s Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA, 19104, USA

    Michael R. Acord, Anne Marie Cahill, Rachelle Durand, Sphoorti Shellikeri, Seth Vatsky & Abhay Srinivasan

  2. Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA

    Michael R. Acord, Anne Marie Cahill, Rachelle Durand, Seth Vatsky & Abhay Srinivasan

  3. Department of Radiology, King’s College Hospital, Denmark Hill, London, UK

    Dean Y. Huang

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  1. Michael R. Acord
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Correspondence to Michael R. Acord.

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A 15-year-old boy presenting for biopsy of a large hepatic mass. Same boy as depicted in Fig. 3. Axial intravenous-contrast-enhanced ultrasound (CEUS) was performed to plan the biopsy trajectory. CEUS reveals an extensive area of necrosis centrally within the mass; however, peripherally, there are areas of viable tumor, which were subsequently targeted for biopsy. Sufficient viable tissue was obtained to provide a diagnosis of undifferentiated embryonal sarcoma (MP4 31484 kb)

A 12-year-old girl presenting with large symptomatic left renal cystic lesion for sclerotherapy injection. Coronal contrast-enhanced ultrasound was performed with direct administration of ultrasound contrast agent through the puncture needle into the cyst following percutaneous access. No communication of the cyst with the renal pelvis was identified, and therefore sclerotherapy proceeded without concern that the sclerosant material would harm the renal collecting system (MP4 17888 kb)

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Acord, M.R., Cahill, A.M., Durand, R. et al. Contrast-enhanced ultrasound in pediatric interventional radiology. Pediatr Radiol 51, 2396–2407 (2021). https://doi.org/10.1007/s00247-020-04853-4

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  • DOI: https://doi.org/10.1007/s00247-020-04853-4

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