shu-508 and Kidney-Diseases

The objective of this case report is to demonstrate the possibility of visualizing intrarenal reflux (IRR) in children using contrast-enhanced harmonic voiding urosonography (VUS). A 10-month-old girl underwent VUS as part of the work-up of acute pyelonephritis of the right kidney. Before and after intravesical administration of US contrast medium (Levovist) the urinary tract was scanned in harmonic imaging mode. Bilateral vesicoureteric reflux was detected (right grade IV, left grade III). Moreover, at the height of the reflux the right kidney parenchyma turned markedly echogenic, corresponding to massive IRR. The voiding cystourethrography that followed confirmed the results of the VUS.

Topics: Contrast Media; Female; Humans; Infant; Kidney Diseases; Polysaccharides; Pyelonephritis; Ultrasonography; Vesico-Ureteral Reflux

Topics: Animals; Blood Pressure; Body Weight; Contrast Media; Dog Diseases; Dogs; Female; Heart Rate; Kidney; Kidney Diseases; Kidney Function Tests; Male; Polysaccharides; Respiration; Statistics, Nonparametric; Ultrasonography, Doppler, Color

The term "pseudotumor" is used to refer to several anatomic variants that can simulate a renal mass, the most frequent of which are hypertrophied column of Bertin, persistence of fetal lobation, and the dromedary or splenic hump. We describe the findings of power Doppler US after the ultrasound contrast agent (Levovist, Schering, Berlin, Germany) administration in 4 patients with a renal focal lesion in whom gray-scale and baseline power Doppler US was not able to certainly differentiate pseudotumor from neoplasm.

Topics: Adult; Carcinoma, Renal Cell; Contrast Media; Diagnosis, Differential; Female; Humans; Image Enhancement; Kidney; Kidney Diseases; Kidney Neoplasms; Male; Middle Aged; Polysaccharides; Ultrasonography, Doppler

Fifty-one patients, with a range of underlying pathologic conditions, were studied prospectively to assess the diagnostic value of echo-enhanced color Doppler sonography in the pediatric and adolescent population Their diagnoses included various tumors, vascular disorders, cerebral bleeding, pathologic conditions of small parts, and focal lesions of parenchymal organs. All patients underwent color Doppler sonography before proceeding to echo-enhanced color Doppler sonography. Diagnoses were confirmed by additional imaging (computed tomography, magnetic resonance imaging, angiography, and scintigraphy) performed as appropriate, with or without histologic study. An additional 20 children did not proceed to echoenhanced color Doppler sonography as color Doppler sonography alone was found to be sufficiently diagnostic. Levovist (SHU 508A), a contrast agent based on galactose-encapsulated air microbubbles, is approved for pediatric applications in Austria and was used as the echo-enhancing agent. Echo-enhanced color Doppler sonography was performed a total of 63 times in 51 patients (mean age, 9.8 years). Compared to color Doppler sonography, echo-enhanced color Doppler sonography either detected or enhanced visualization of pathologic conditions in 55 investigations (87.3%), yielding an overall accuracy of 95.2% (sensitivity, 95%), versus 65.7% with color Doppler sonography. One spinal arteriovenous malformation, one cerebral cavernoma, and one liver lesion were missed. The contrast material was easy to administer; no adverse reactions were observed. We conclude that echoenhanced color Doppler sonography is beneficial in pediatric sonography. It enhances visualization of vessels and perfusion, thus offering a nonionizing imaging tool for detection and follow-up evaluation of pathologic conditions with disturbed vasculature in specific cases. In infants and in persons with superficial lesions it did not offer significant advantages over color Doppler sonography.

Topics: Adolescent; Adult; Age Factors; Arteriovenous Malformations; Child; Child, Preschool; Contrast Media; Female; Humans; Image Enhancement; Infant; Infant, Newborn; Kidney Diseases; Liver Diseases; Magnetic Resonance Imaging; Male; Neoplasms; Polysaccharides; Prospective Studies; Sensitivity and Specificity; Tomography, Emission-Computed; Tomography, X-Ray Computed; Ultrasonography, Doppler, Color; Urography; Vascular Diseases

Topics: Contrast Media; Humans; Kidney Diseases; Kidney Neoplasms; Polysaccharides; Ultrasonography