Potential causes of insufficient bladder contrast opacification and premature microbubble destruction during contrast-enhanced voiding urosonography in children

J Clin Ultrasound. 2019 Jan;47(1):36-41. doi: 10.1002/jcu.22656. Epub 2018 Nov 4.

Abstract

Contrast-enhanced voiding urosonography (ceVUS) has been recognized as a child-friendly examination with high diagnostic accuracy for vesicoureteric reflux detection. A single bolus and the infusion techniques of ceVUS are described. Insufficient bladder contrast opacification during the filling phase and premature destruction of SonoVue microbubbles might occur. Data regarding SonoVue's features, doses, bladder contrast opacification, US bladder parameters, urine catheter, antibiotic prophylaxis, and childrens behaviors were collected to discover the possible causes of the contrast vanishing observed during bladder filling in 10% of examinations and in the later phase of ceVUS in 5% of examinations. An updated ceVUS examination protocol is suggested.

Keywords: contrast-enhanced voiding urosonography; microbubbles; pediatrics; ultrasound contrast agent; vesicoureteric reflux.

MeSH terms

  • Child, Preschool
  • Contrast Media*
  • Female
  • Humans
  • Image Enhancement / methods*
  • Male
  • Microbubbles*
  • Phospholipids*
  • Reproducibility of Results
  • Retrospective Studies
  • Sulfur Hexafluoride*
  • Time Factors
  • Ultrasonography / methods*
  • Ureter / diagnostic imaging
  • Urinary Bladder / diagnostic imaging
  • Vesico-Ureteral Reflux / diagnostic imaging*

Substances

  • Contrast Media
  • Phospholipids
  • contrast agent BR1
  • Sulfur Hexafluoride