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March 30, 2021 — Pediatric Radiology


The increasing use of contrast-enhanced ultrasound (CEUS) has opened exciting new frontiers for musculoskeletal applications inadults and children. The most common musculoskeletal-re lated CEUS applications in adults are for detecting inflammatory jointdiseases, imaging skeletal muscles and tendon perfusion, imaging postoperative viability of osseous and osseocutaneous tissueflaps, and evaluating the malignant potential of soft-tissu e masses. Pediatric musculosk eletal-related CEUS has been applied forimaging juvenile idiopathic arthritis and Legg–Calvé–Perthes disease and for evaluating femoral head perfusion following surgicalhip reduction in children with developmental hip dysplasia. CEUS can improve visualization of the capillary network in superficialand deep tissues and also in states of slow- or low-volume blood flow. In addition, measurements of blood flow imaging parametersperformed by quantitativ e CEUS are valuable when monitoring the outcome of treatment interventions. In this review article wepresent current experience regarding a wide range of CEUS applications in musculoskeletal conditions in adults and children, withemphasis on the latter, and discuss imaging techniques and CEUS findings in musculoskeletal applications.

Authors: Aikaterini Ntoulia1, Carol E. Barnewolt2, Andrea S. Doria3, Victor M. Ho-Fung1, Norbert Lorenz4, Hans-Joachim Mentzel5, Susan J. Back1

1 Department of Radiology, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
2 Department of Radiology, Boston Children’s Hospital, Harvard University, Boston, MA, USA
3 Department of Medical Imaging, The Hospital for Sick Children, University of Toronto, ON, Canada
4 Children’s Hospital, Dresden Municipal Hospital, Teaching-Hospital of Technical University, Germany
5 Pediatric Radiology, Institute of Diagnostic and Interventional Radiology, University Hospital of Jena, Germany

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