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February 18, 2021 — Pediatric Radiology


Brain contrast-enhanced ultrasound (CEUS) is an emerging application that can complement gray-scale US and yield additionalinsights into cerebral flow dynamics. CEUS uses intravenous injection of ultrasound contrast agents (UCAs) to highlight tissueperfusion and thus more clearly delineate cerebral pathologies including stroke, hypoxic–ischemic injury and focal lesions suchas tumors and vascular malformations. It can be applied not only in infants with open fontanelles but also in older children andadults via a transtemporal window or surgically created acoustic window. Advancements in CEUS technology and post-processing methods for quantitative analysis of UCA kinetics further elucidate cerebral microcirculation. In this review articlewe discuss the CEUS examination protocol for brain imaging in children, current clinical applications and future directions forresearch and clinical uses of brain CEUS.

Authors: Misun Hwang1&Carol E. Barnewolt2&Jörg Jüngert3&Francesco Prada4&Anush Sridharan1&Ryne A. Didier1

1 Department of Radiology, Children’s Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA,
2 Department of Radiology, Boston Children’s Hospital, Harvard University, Boston, MA, USA
3 Department of Pediatrics, Friedrich-Alexander University Erlangen – Nürnberg, Erlangen, Germany
4 Acoustic Neuroimaging and Therapy Laboratory, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy

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