Advanced Ultrasound Techniques for Pediatric Imaging

Abstract

Ultrasound has become a useful tool in the workup of pediatric patients because of the highly convenient, cost-effective, and safe nature of the examination. With rapid advancements in anatomic and functional ultrasound techniques over the recent years, the diagnostic and interventional utility of ultrasound has risen tremendously. Advanced ultrasound techniques constitute a suite of new technologies that employ microbubbles to provide contrast and enhance flow visualization, elastography to measure tissue stiffness, ultrafast Doppler to deliver high spatiotemporal resolution of flow, three-and four-dimensional technique to generate accurate spatiotemporal representation of anatomy, and high-frequency imaging to delineate anatomic structures at a resolution down to 30 mm. Application of these techniques can enhance the diagnosis of organ injury, viable tumor, and vascular pathologies at bedside. This has significant clinical implications in pediatric patients who are not easy candidates for lengthy MRI or radiation-requiring examination, and are also in need of a highly sensitive bedside technique for therapeutic guidance. To best use the currently available, advanced ultrasound techniques for pediatric patients, it is necessary to understand the diagnostic utility of each technique. In this review, we will educate the readers of emerging ultrasound techniques and their respective clinical applications.

Progress in the Application of Ultrasound Elastography for Brain Diseases

“…The speed of shear wave propagation depends on the stiffness of the tissue. 16 At present, the shear wave imaging system usually uses the equation E = 3q(c s ) 2 to calculate the Young's modulus, where q represents the tissue density, and c s represents the shear wave velocity. 16,17 Most commercial suppliers provide automated computing systems that convert kilopascals to meters per second and meters per second to kilopascals.…”

“…In the past few years, contrast-enhanced US, US elastography, and ultrafast Doppler imaging have enhanced diagnostic importance in brain diseases. 2,3 With the progress of these technologies, full familiarity with these new technologies and devices is very important for successful clinical applications and improvements in prognoses. Contrast-enhanced US can be used to show different degrees of brain injury, such as cerebral hemorrhage, hypoxic ischemic brain injury, cerebral infarction, and other diseases.…”

“…It is another functional US technology, which can quantify tissue hardness and reflect the tissue composition or structure, edema, injury, and perfusion. 2 Ultrasound elastography plays an important role in traumatic brain injury (TBI), brain tumors, ischemic stroke, and hypoxic ischemic encephalopathy (HIE). 2 This review will provide a comprehensive update on US elastographic techniques currently available in animal and clinical trials.…”

“…Compared with magnetic resonance imaging (MRI), its limitations include operator experience, lack of quantification, and lower prognoses. In the past few years, contrast‐enhanced US, US elastography, and ultrafast Doppler imaging have enhanced diagnostic importance in brain diseases . With the progress of these technologies, full familiarity with these new technologies and devices is very important for successful clinical applications and improvements in prognoses.…”

“…Ultrasound elastography is a noninvasive imaging technology, which does not need an additional contrast agent. It is another functional US technology, which can quantify tissue hardness and reflect the tissue composition or structure, edema, injury, and perfusion . Ultrasound elastography plays an important role in traumatic brain injury (TBI), brain tumors, ischemic stroke, and hypoxic ischemic encephalopathy (HIE) .…”