Contrast-enhanced ultrasound performed under urgent conditions. Indications, review of the technique, clinical examples and limitations.

Contrast-enhanced ultrasound (CEUS) is an imaging technique with various indications, most of which refer to scheduled examinations. However, CEUS can also be performed under urgent conditions for the investigation of many different clinical questions. This article reviews basic physics of ultrasound contrast agents and examines the commonest urgent clinical applications of CEUS. These include, among others, abdominal solid organ trauma and infarcts, scrotal and penile pathology and blood vessel imaging. Patients can be examined with a very short time delay at their bedside, without exposure to ionising radiation or risk of anaphylactic reaction and renal failure, while contraindications are minimal. CEUS technique is described for various urgent indications and imaging examples from our department's experience are presented. Safety matters and limitations of CEUS are also mentioned. Teaching Points • Contrast-enhanced ultrasound (CEUS) can be performed urgently for various clinical applications. • Abdominal indications include solid organ trauma and infarcts. • CEUS in abdominal organ trauma correlates well with CT and can replace it for patient follow-up. • CEUS images testicular torsion, infection and infarction, as well as testicular and penile trauma. • Blood vessels can be assessed with CEUS for obstruction, aneurysm, thrombosis and dissection.

Contrast enhanced ultrasound of the kidneys: what is it capable of?

One of the many imaging uses of contrast enhanced ultrasound (CEUS) is studying a wide variety of kidney pathology, due to its ability to detect microvascular blood flow in real time without affecting renal function. CEUS enables dynamic assessment and quantification of microvascularisation up to capillary perfusion. The objective of this paper is to briefly refresh basic knowledge of ultrasound (US) contrast agents' physical properties, to study technical details of CEUS scanning in the kidneys, and to review the commonest renal indications for CEUS, with imaging examples in comparison to baseline unenhanced US and computed tomography when performed. Safety matters and limitations of CEUS of the kidneys are also discussed.

Emergency ultrasound of the scrotum: a review of the commonest pathologic conditions.

Ultrasound is the first imaging modality to be performed in emergency conditions of the scrotum. The commonest pathologic entities are divided into the 4 following groups: torsion, trauma, infection, and tumors. Sonographic examination should be performed as soon as possible to ensure fast diagnosis and treatment. Less acute conditions can also be noted while scanning on an emergency basis, such as anatomic variants, hydrocele, oscheocele, clinically evident varicocele, calcifications, etc. Although not threatening for scrotal integrity, they should be assessed during an emergency examination or later on. In this article, complex scrotal anatomy is reviewed and the basic examination technique is described. The commonest emergency conditions are analyzed, along with their pathophysiological basis. Nonemergent entities are also briefly mentioned. Ultrasound images of the commonest emergency conditions are demonstrated.