Abstract
The aim of this study is to describe premature microbubbles destruction with contrast-enhanced voiding urosonography (ce-VUS) in children using 2nd-generation ultrasound contrast agents (UCA) and to hypothesize about the reason. 141 children (61 females and 80 males) were included in the study, with mean age of 3.3 years (range 4 weeks–16.0 years), who underwent ce-VUS examination between 2011 and 2014. Premature destruction of the microbubbles in the urinary bladder during ce-VUS was observed in 11 children (7.8%). In all these cases the voiding phase of ce-VUS examination could not be performed because of destroyed UCA microbubbles. This was noted in anxious, crying infants and children with restricted voiding. The premature destruction of ultrasound contrast agent during ce-VUS is an underreported, important limitation of ce-VUS, which prevents evaluation of the voiding phase and the establishment of vesicoureteric reflux (VUR). This was particularly noted in crying infants and children.
Highlights
Contrast-enhanced voiding urosonography is the most common application of second-generation ultrasound contrast agents (UCA) in children [1]
The Contrast-enhanced voiding urosonography (ce-VUS) is generally considered as a promising tool with high accuracy to diagnose vesicoureteric reflux (VUR), comparable to standard voiding cystourethrography (VCUG) [2,3,4]
As far as experiences concerning the use of the second-generation UCA in contrast-enhanced voiding urosonography are still limited, all information about the duration of bladder filling, first symptoms of destruction and subtotal/total destruction or any side effects and possible technical problems like crying, BioMed Research International problems with voiding, and so forth were collected in study reports of all cases
Summary
Contrast-enhanced voiding urosonography (ce-VUS) is the most common application of second-generation ultrasound contrast agents (UCA) in children [1]. The ce-VUS is generally considered as a promising tool with high accuracy to diagnose vesicoureteric reflux (VUR), comparable to standard voiding cystourethrography (VCUG) [2,3,4]. To the best of our knowledge, there are no published reports about difficulties that may arise in the case of premature intravesical destruction of microbubbles. In this post hoc analysis, we describe a series of patients in whom this problem occurred and analyzed the mechanisms possibly responsible for this phenomenon
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