Department of Radiology, UPMC Children's Hospital of Pittsburgh, 4401 Penn Ave, 2nd Fl Radiology, Pittsburgh, PA 15224.
Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, PA.
AJR Am J Roentgenol. 2021 Nov;217(5):1217-1231. doi: 10.2214/AJR.21.25713. Epub 2021 Apr 28.
Contrast-enhanced ultrasound (CEUS) utilization is expanding rapidly, particularly in children, in whom the modality offers the important advantages of dynamic evaluation of the vasculature, portability, lack of ionizing radiation, and lack of need for sedation. Accumulating data establish an excellent safety profile of ultrasound contrast agents (UCAs) in children. Although UCAs have been FDA-approved only for IV use in children for characterizing focal liver lesions and for use in children during echocardiography, off-label applications are expanding the diagnostic potential of ultrasound. Focal liver lesion evaluation is the most common use of CEUS, and the American College of Radiology Pediatric LI-RADS Working Group recommends including CEUS for evaluation of a newly discovered focal liver lesion in many circumstances. Data also support the role of CEUS in hemodynamically stable children with blunt abdominal trauma, and CEUS is becoming a potential alternative to CT in this setting. Additional potential applications that require further study include evaluation of pathology in the lung, spleen, brain, pancreas, bowel, kidney, female pelvis, and scrotum. This article explores the implementation of CEUS in children, describing basic principles of UCAs and CEUS technique and summarizing current and potential IV diagnostic applications based on pediatric-specific supporting evidence.
对比增强超声（CEUS）的应用正在迅速扩展，尤其是在儿科领域，该技术具有动态评估血管、便携性、无电离辐射以及无需镇静等重要优势。越来越多的数据证实了超声对比剂（UCA）在儿童中的安全性良好。尽管 UCA 仅获得 FDA 批准可用于儿科静脉内应用，以评估局灶性肝脏病变和在儿科心脏超声检查中使用，但超说明书应用正在扩大超声的诊断潜力。局灶性肝脏病变的评估是 CEUS 的最常见应用，美国放射学会儿科 LI-RADS 工作组建议在许多情况下将 CEUS 用于新发现的局灶性肝脏病变的评估。数据还支持在血流动力学稳定的钝性腹部创伤儿童中使用 CEUS，在这种情况下，CEUS 正成为 CT 的潜在替代方法。需要进一步研究的其他潜在应用包括评估肺部、脾脏、大脑、胰腺、肠道、肾脏、女性盆腔和阴囊的病变。本文探讨了 CEUS 在儿科中的应用，描述了 UCA 和 CEUS 技术的基本原理，并根据儿科具体的支持证据总结了当前和潜在的 IV 诊断应用。
