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Z Gastroenterol 2014; 52(10): 1178-1184
DOI: 10.1055/s-0034-1366766
Übersicht
© Georg Thieme Verlag KG Stuttgart · New York

Contrast Enhanced Ultrasound in Pediatric Patients: A Real Challenge

Kontrastmittelsonografie in der Pädiatrie: eine Herausforderung
D. G. Schreiber-Dietrich
1   Department of Internal Medicine, Uhlandstr. 7, Caritas-Krankenhaus Bad Mergentheim, 97980 Bad Mergentheim, Germany
,
X. W. Cui
1   Department of Internal Medicine, Uhlandstr. 7, Caritas-Krankenhaus Bad Mergentheim, 97980 Bad Mergentheim, Germany
,
F. Piscaglia
2   Internal Medicine, University of Bologna, Italy
,
O. H. Gilja
3   National Centre for Ultrasound in Gastroenterology, Department of Medicine, Haukeland University Hospital, Bergen, Norway
4   Department of Clinical Medicine, University of Bergen, Bergen, Norway
,
C. F. Dietrich
1   Department of Internal Medicine, Uhlandstr. 7, Caritas-Krankenhaus Bad Mergentheim, 97980 Bad Mergentheim, Germany
› Author Affiliations
Further Information

Publication History

04 February 2014

15 June 2014

Publication Date:
14 October 2014 (online)

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Abstract

Ultrasound (US) imaging in the paediatric population has been a routine technique for decades, in part because of the advantages it offers over other imaging modalities. Off-label use (and its funding) is of the utmost importance in paediatrics because many drugs have not been evaluated in randomised trials in children. As a consequence such drugs are not specifically approved for use in children. This is also true for the contrast agents used in CEUS. The off-label use of CEUS in paediatric patients illustrates the need to deal with unresolved legal issues while at the same time balancing this with the need for high diagnostic performance in daily clinical routine. In addition to approved indications with a focus on the liver and Doppler enhancement, CEUS is safe and effective for the examination of many organs, as recently highlighted by the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB). This article provides a summary of the available literature describing the utility of CEUS in paediatric patients. Furthermore, we suggest the establishment of a registry to collect data on safety and applications of ultrasound contrast agents in children. A paediatric registry has recently been introduced by EFSUMB (www.efsumb.org).

Zusammenfassung

Ultraschall ist ein Standardverfahren in der Pädiatrie. Vorteile gegenüber radiologischen Methoden sind offensichtlich. Die Anwendung nicht speziell für Kinder zugelassener Medikamente und Kontrastmittel stellt ein relevantes Problem in der Pädiatrie dar. Dies gilt ebenfalls für Ultraschallkontrastmittel. Diese Thematik ist brandaktuell und illustriert offensichtliche Schwächen in unserem Gesundheitssystem und den Europäischen Zulassungsprozessen. Die Vorteile und Sicherheitsaspekte von CEUS wurden durch die European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) in Leitlinien publiziert. Dieser Artikel fasst aktuelles Wissen zusammen und fokussiert auf den Nutzen von CEUS in der Kinderheilkunde. Ziel dieses Artikel ist es auch, eine Datensammlung zu generieren, die die Anwendungsmöglichkeiten und Sicherheit von CEUS im Kindesalter abbildet. Die EFSUMB hat eine „Pediatric Registry“ zu diesem Zwecke eingerichtet (www.efsumb.org).

Schlüsselwörter

Leber - Charakterisierung - Microbubble - Richtlinien - Register

Key words

liver - characterization - microbubble - guidelines - registry
 

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