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CEUS : Interpretation of Focal Liver Lesions in Children

  • #Ultrasound System>General Imaging
  • writerPaul S. Sidhu MRCP FRCR
  • date2018.05.01
The use on contrast enhanced ultrasound (CEUS) in adults is well established, with experience worldwide exceeding 20 years, with numerous studies and guidelines confirming the efficacy of the technique1;2. Until recently there was no license for the use of ultrasound contrast agents (UCA) in children, but the application of this technique in children would have considerable benefits3;4, predominantly in the reduction of radiation dose associated with Computed Tomography (CT) and the absence of the ill effects associated with sedation or anaesthesia of a Magnetic Resonance (MR) study, as well as the associated morbidity of contrast agents used in CT and MR imaging3-5. This is particularly pertinent as the currently commonly used UCA, Lumason™ (Bracco, SpA, Milan) has an excellent safety record in adults, and with mounting evidence of safety in children6. Furthermore a recent analysis of the safety and cost-effectiveness in children confirms that this scenario in the adults is replicated in children7. Recently, the Food and Drug Administration (FDA) approved the use of Lumason™ for the assessment of focal liver lesions both in the adult and pediatric patients, allowing for this technique to be deployed in children when an incidental focal liver lesion has been identified on an sonographic examination8. The accuracy of the use of UCA in indeterminate focal liver lesions in children has been previously investigated with favourable findings9. Furthermore, many practitioners, particularly in European countries have for many years used UCA ‘off-label’ in children, establishing the practicality and usefulness in assessing solid organ injury in blunt abdominal trauma10.