Schreiber-Dietrich D G, Cui X W, Piscaglia F, Gilja O H, Dietrich C F
Department of Internal Medicine, Uhlandstr. 7, Caritas-Krankenhaus Bad Mergentheim, 97980 Bad Mergentheim, Germany.
Internal Medicine, University of Bologna, Italy.
Z Gastroenterol. 2014 Oct;52(10):1178-84. doi: 10.1055/s-0034-1366766. Epub 2014 Oct 14.
Ultrasound (US) imaging in the paediatric population has been a routine technique for decades, in part because of the advantages it offers over other imaging modalities. Off-label use (and its funding) is of the utmost importance in paediatrics because many drugs have not been evaluated in randomised trials in children. As a consequence such drugs are not specifically approved for use in children. This is also true for the contrast agents used in CEUS. The off-label use of CEUS in paediatric patients illustrates the need to deal with unresolved legal issues while at the same time balancing this with the need for high diagnostic performance in daily clinical routine. In addition to approved indications with a focus on the liver and Doppler enhancement, CEUS is safe and effective for the examination of many organs, as recently highlighted by the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB). This article provides a summary of the available literature describing the utility of CEUS in paediatric patients. Furthermore, we suggest the establishment of a registry to collect data on safety and applications of ultrasound contrast agents in children. A paediatric registry has recently been introduced by EFSUMB (www.efsumb.org).
几十年来，超声（US）成像在儿科人群中一直是一项常规技术，部分原因在于它相对于其他成像方式所具有的优势。在儿科领域，超说明书用药（及其资金支持）至关重要，因为许多药物尚未在儿童随机试验中进行评估。因此，这类药物未被专门批准用于儿童。超声造影剂增强超声（CEUS）的情况也是如此。儿科患者中CEUS的超说明书使用表明，在处理尚未解决的法律问题的同时，还需要在日常临床实践中兼顾对高诊断性能的需求。除了已获批的以肝脏和多普勒增强为重点的适应症外，正如欧洲医学与生物学超声学会联合会（EFSUMB）最近所强调的，CEUS对许多器官的检查是安全有效的。本文总结了现有文献中关于CEUS在儿科患者中的应用情况。此外，我们建议建立一个登记处，以收集有关儿童超声造影剂安全性和应用的数据。EFSUMB最近推出了一个儿科登记处（www.efsumb.org）。
