Sandrine Chapuy, Presenter: Nothing to Disclose

Philippe Manzoni MD, Abstract Co-Author: Nothing to Disclose

Adrian Imre Kastler MD, MSc, Abstract Co-Author: Nothing to Disclose

Sebastien Louis Aubry MD, PHD, Abstract Co-Author: Nothing to Disclose

Eric Delabrousse MD, Abstract Co-Author: Nothing to Disclose

Bruno Alfred Kastler MD, PhD, Abstract Co-Author: Nothing to Disclose

Avoiding ionizing radiations is of special interest particularly in a pediatric population. Contrast enhanced ultrasound (ECUS) is already largely used in adults but is is yet to be validated in children as ECUS agents have not received marketing authorization in pediatrics. The aim of our study, which received approval from the local ethics committee, was to analyze the potential diagnostic benefits of SonoVue ® in pediatric pathology.

A total of 611 ECUS were performed in 471 children (240 females, 231 males with a mean age of 8,8 years, range 1 day to 17 years) over the last 8 years. The following ultrasound accessible organs where assessed: Head and Neck: 46 cases, Liver : 132 cases, Kidney : 156 cases, Abdomen : 177 cases, Pelvis: 51 cases, Thorax : 18 cases , bone and soft tissue : 21 cases, reflux : 10 cases. The cohort was divided into two groups: diagnostic ECUS (421 examinations) and follow up ECUS (190). In each group, examinations were divided into the following sub-groups: Sub-group 0 : No added information compared to non-enhanced US, Sub-group 1: ECUS findings are superior to that of non enhanced US but less informative than MRI or CT. Sub-group 2 : Insufficient imaging US findings and different from that of MRI or CT. Sub-group 3 : unclear diagnosis. Sub-group 4: Definitive diagnosis.

Results were classified according to the organs analyzed, the type of pathology and diagnostic gold standard examination used (histology, CT or MRI, follow up). In the diagnostic ECUS group, ECUS led to a definitive diagnosis (Sub-group 4) in 61% of cases. Remaining sub-group distribution were as follows: SG 0 : 2.4%, SG 1 : 5%, SG 2 : 8.2%, SG 3 : 22.4%, In the follow up ECUS group, ECUS led to a definite diagnosis in 88% of cases (SG 4). Remaining sub-group distribution were as follows: SG 1 : 4.8%, SG 2 : 2.6%, SG 3 : 3.7% No major side effects occurred.

In pediatric pathology assessment, ECUS offers very interesting non-ionizing, real time, bed-side diagnostic perspectives, with no side effects and at moderate costs.

Contrast enhanced ultrasound is a safe and accurate imaging modality in children and allows to avoid the use of ionizing examination (CT) .

Chapuy, S, Manzoni, P, Kastler, A, Aubry, S, Delabrousse, E, Kastler, B, Contrast Enhanced Ultrasound in Pediatrics: Diagnostic Value and Feasibility in 611 Cases.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12032790.html