1. To learn about the application of CEUS in children.
2. To understand the legal implications of using CEUS off-label in children.
3. To appreciate the potential of combining ultrasound with CEUS in assessing the child.
4. To become familiar with the techniques and applications of CEUS.
Ultrasound is gentle and patient-friendly imaging technique, with the ability to image in real time, with superb resolution, and the advantage of being less expensive than other imaging techniques. An ultrasound machine is the ultimate ‘plug-and-play’ modality. The uniqueness of real-time, safe, portability makes this an ideal solution for imaging in children. The child is reassured by the presence of the examiner explaining, the parent comforting, and the ability to move and question all the time aids the child’s tolerance of the imaging procedure. Many areas of the body are inaccessible to an ultrasound examination, where other imaging techniques are superior. Nevertheless, when ultrasound visualises an organ, it has the best resolution of all the techniques. This is particularly true for abdominal work in the child, where often the body habitus allows for a detailed examination. Ultrasound has long been the poor relation with respect to contrast examinations, often incorrectly a non-contrast ultrasound in the adult is compared unfavourably with the contrast-enhanced CT. Microbubble ultrasound contrast agents have been in clinical practice in adults for 20 years, most used off-licence in areas of need, revolutionising many aspects of the diagnostic capabilities of an ultrasound examination. The introduction of contrast-enhanced ultrasound (CEUS) has been led by a number of pioneers, recognising the usefulness in aiding diagnosis and management with minimal morbidity to the child. This lecture will outline the pathway of CEUS in children to the sanctioning by the FDA.