Contrast-Enhanced Ultrasound of Pediatric Focal Liver Lesions

Abstract

Contrast-enhanced ultrasound (CEUS) is being increasingly used as an adjunctive tool to greyscale and colour Doppler ultrasound for characterising focal liver lesions in children, with advantages of lack of ionising radiation, no sedation needs and excellent safety profile of the ultrasound contrast agent. In the United States it has Food and Drug Administration approval for use in imaging focal liver lesions in both adults and children. The profile of behaviour of the ultrasound contrast agent is well established in adults, with the unique dual blood supply of the liver allowing for characterisation of focal liver lesions in real-time through the arterial, early portal venous and late portal venous phases, establishing the diagnosis. This ability to monitor the vascular phases of enhancement in real time is unique to a CEUS examination and particularly useful in children. The use of paediatric CEUS in charactering focal liver lesion is discussed in addition to the safety and technical aspects of a CEUS examination, highlighting the exceptional utility in children.