Department of Radiology, King's College Hospital, Denmark Hill, London, SE5 9RS, UK.
Department of Radiology, Perelman School of Medicine, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, USA.
Pediatr Radiol. 2021 Nov;51(12):2181-2197. doi: 10.1007/s00247-021-04976-2. Epub 2021 May 12.
Contrast-enhanced ultrasound (CEUS) is increasingly being used in children. One of the most common referrals for CEUS performance is characterization of indeterminate focal liver lesions and follow-up of known liver lesions. In this setting, CEUS is performed with intravenous administration of ultrasound contrast agents (UCAs). When injected into a vein, UCA microbubbles remain confined within the vascular network until they dissipate. Therefore, visualization of UCA within the tissues and lesions corresponds to true blood flow. CEUS enables continuous, real-time observation of the enhancement pattern of a focal liver lesion, allowing in most cases for a definite diagnosis and obviating the need for further cross-sectional imaging or other interventional procedures. The recent approval of Lumason (Bracco Diagnostics, Monroe Township, NJ) for pediatric liver CEUS applications has spurred the widespread use of CEUS. In this review article we describe the role of CEUS in pediatric liver applications, focusing on the examination technique and interpretation of main imaging findings of the most commonly encountered benign and malignant focal liver lesions. We also compare the diagnostic performance of CEUS with other imaging modalities for accurate characterization of focal liver lesions.
超声造影（CEUS）在儿童中应用越来越广泛。CEUS 最常见的适应证之一是对不明原因的局灶性肝脏病变进行定性诊断和对已知肝脏病变进行随访。在这种情况下，通过静脉内给予超声造影剂（UCA）来进行 CEUS。当 UCA 注入静脉后，微气泡会一直局限在血管网络内，直到它们消散。因此，UCA 在组织和病变内的显影对应于真正的血流。CEUS 可以连续实时观察局灶性肝脏病变的增强模式，在大多数情况下可以明确诊断，避免了进一步进行横断面成像或其他介入性操作的需要。最近，Lumason（Bracco Diagnostics，Monroe Township，NJ）获得批准用于儿科肝脏 CEUS 应用，这推动了 CEUS 的广泛应用。在这篇综述文章中，我们描述了 CEUS 在儿科肝脏应用中的作用，重点介绍了最常见的良性和恶性局灶性肝脏病变的检查技术和主要影像学表现的解读。我们还比较了 CEUS 与其他成像方式在准确定性局灶性肝脏病变方面的诊断性能。
