Contrast-enhanced Sonographic Detection of Vesicoureteral Reflux in Children: Comparison with Voiding Cystourethrography

Abstract

It is suggested that CES is an accurate and reliable imaging modality for the detection of VUR, although it cannot replace VCUG in some cases. In addition, CES can be recommended in the follow-up of VUR, reducing the number of radiographic investigations.

Transfontanellar contrast enhanced ultrasound in infants: Initial experience

“…The use of contrast agents in children has been previously reported in the evaluation of vesico-ureteral reflux [28,29]. Moreover, other sporadic use of off label US contrast media: evaluation of traumatic injury (spleen [30], liver, pancreas [31,32], testicular), gastroesophageal reflux [33], diagnosis of Meckel diverticum [34], appendicitis [35] or appendagitis [36].…”

Voiding urosonography with ultrasound contrast agents for the diagnosis of vesicoureteric reflux in children

“…A number of different names and acronyms have been put forward to denote US examination for the diagnosis of VUR using intravesical UCAs. These include simply “sonography/ultrasound” [ 4 – 6 ], “reflux sonography” [ 7 ], “cystography” [ 8 – 10 ], “cystosonography” [ 11 – 15 ], “cystourethrosonography” [ 16 ] and “urosonography” [ 17 – 23 ]. They are more often used in combination with one or more of the following terms: “echo-enhanced”, “contrast-enhanced” and “voiding”.…”

Ultrasound contrast media in paediatric patients: is it an off-label use? Regulatory requirements and radiologist’s liability

“…Off-label: legal provisions and liability of the ultrasound radiologist A comprehensive analysis of the relevant regulatory framework reveals that in the last 10 years, the Italian national Table 3 Possible application of CEUS in the paediatric age Historic (or classic) applications Evaluation of vesico-ureteral reflux: urosonography [13][14][15][16][17] Evaluation of traumatic injury (liver, spleen, pancreas) [5,[18][19][20] Evaluation of gastro-oesophageal reflux [21] Atypical (or borderline) applications Diagnosis of Meckel diverticulum [22] Evaluation of epiploic appendagitis [23] Evaluation of revascularisation flow in Perthes disease [24] Diagnosis of acute appendicitis [25,26] Future applications Evaluation of vascular disease (angioma, arteriovenous malformations) [27,28] Advice in paediatric oncology for solid tumours (e.g. osteosarcoma, neuroblastoma, etc.)…”

“…osteosarcoma, neuroblastoma, etc.) [29] Increase in diagnostic confidence for doubtful testicular torsion, above all in infants and toddlers [30] [13][14][15][16][17] Valutazione delle lesioni traumatiche (fegato, milza, pancreas) [5,[18][19][20] Valutazione del reflusso gastro-esofageo [21] Applicazioni atipiche (o di frontiera) Ricerca del diverticolo di Meckel [22] Valutazione in pazienti con flogosi delle appendici epiploiche [23] Valutazione della rivascolarizzazione della testa del femore nella malattia di Perthes [24] Valutazione nei pazienti con appendicite acuta [25,26] Applicazioni futuribili Valutazione in pazienti con lesioni vascolari (angiomi/malformazioni vascolari) [27,28] Informazioni in oncologia pediatrica in particolari tipi di tumori solidi (es. osteosarcoma, neuroblastoma, ecc.)…”