Contrast Enhanced Ultrasound

Also known as: CEUS

What is contrast enhanced ultrasound?

Ultrasound is a common medical exam used to image the organs inside the body. Ultrasound uses sound waves to produce images and does not use radiation. It is typically performed by running a small probe on the patient’s skin. Contrast can be used to better define organs or lesions and is called Contrast Enhanced Ultrasound.

Ultrasound contrast is very different form the kind of contrast used in CT and MRI. Ultrasound contrast contains tiny bubbles and is injected into the blood stream or given through a catheter into the urinary bladder.

What happens during the procedure?

Contrast ultrasound typically does not require sedation or other major preparation. Typically, the patient lies flat while the radiologist or technologist scans the patient. A water-based gel is applied to the skin, and then the ultrasound probe is positioned and moved around the area of interest to produce images inside the body.

Contrast enhanced voiding urosonography (CEVUS)

CEVUS is similar to a conventional voiding cystourogram (VCUG) but does not use radiation. This test is performed to evaluate for vesicoureteral reflux which may be causing urinary tract infections or to evaluate the anatomy. The contrast does not enter into the blood stream and only fills the renal collecting system and bladder. A voiding contrast ultrasound should not be performed when the patient has an active infection or fever.

Baseline images are obtained of the bladder and kidneys using the ultrasound probe. Then a small catheter is gently placed into the urethra by the nurse or technologist. The ultrasound contrast is then slowly administered through the catheter to fill the bladder. Images of the kidneys, bladder and urethra are obtained using the ultrasound probe to look for reflux of contrast into the kidneys from the bladder while the patient is lying on their back. Images are also obtained while the patient is voiding/urinating. Images of the child voiding may be obtained in the seated position on a portable potty or toilet if toilet-trained.

Contrast enhanced Liver Ultrasound

CE liver ultrasound is used to evaluate known liver lesions or masses. Usually it is performed as follow up after an MRI or CT to see if the mass is stable (not changing) or to evaluate infantile hemangiomas in the liver.

Baseline images of the liver are obtained first. Then an intravenous catheter is placed in the arm by a nurse or the doctor. Contrast is injected into the vein slowly while images are obtained by the technologist or doctor. Sometimes a second injection may be needed for better evaluation or to see a second lesion.

Injected contrast is removed from the blood by the lungs and then exhaled with normal breathing. This occurs mostly in the first minute after injection.

Is any special preparation needed?

Generally, there is no special preparation needed for a contrast enhanced ultrasound.

What are the risk factors?

Since the contrast is made of microbubbles it is very safe and can be used in patients who have liver or kidney problems. Allergic reactions to the contrast are extremely rare. There may be discomfort or mild pain associated with placement of the small urinary catheter or intravenous catheter.

Reviewed by: Rachel Pevsner Crum, DO

This page was last updated on: February 22, 2021 10:14 AM

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