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01.06.2015 | Original Article

Contrast-enhanced voiding urosonography phantom study: intravenous iodinated and gadolinium-based contrast agents may cause false-negative results in assessment of vesicoureteral reflux in children

verfasst von: Simon Veldhoen, Alexander Sauer, Tobias Gassenmaier, Bernhard Petritsch, Stefan Herz, Philipp Blanke, Thorsten Derlin, Thorsten A. Bley, Clemens Wirth

Erschienen in: Pediatric Radiology | Ausgabe 6/2015

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Abstract

Background

Contrast-enhanced voiding urosonography (ce-VUS) is commonly requested simultaneously to other diagnostic imaging necessitating intravenous contrast agents. To date there is limited knowldedge about intravesical interactions between different types of contrast agents.

Objective

To assess the effect of excreted intravenous iodinated and gadolinium-based contrast agents on the intravesical distribution of ultrasound contrast within contrast-enhanced voiding urosonography.

Materials and methods

Iodinated (iomeprol, iopamidol) and gadolinium-based (gadoterate meglumine) contrast agents were diluted to bladder concentration and injected into balloons filled with saline solution. CT scans were performed to assess the contrast distribution in these phantoms. Regions of interest were placed at the top and bottom side of each balloon and Hounsfield units (HU) were measured. Three other balloons were filled with saline solution and contrast media likewise. The ultrasound contrast agent sulphur hexafluoride was added and its distribution was assessed using sonography.

Results

MDCT scans showed a separation of two liquid layers in all bladder phantoms with the contrast layers located at the bottom and the saline solution at the top. Significant differences of the HU measurements at the top and bottom side were observed (P < 0.001–0.007). Following injection of ultrasound contrast agent, US showed its distribution exclusively among the saline solution.

Conclusions

False-negative results of contrast-enhanced voiding urosonography may occur if it is performed shortly after imaging procedures requiring intravenous contrast.

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Titel: Contrast-enhanced voiding urosonography phantom study: intravenous iodinated and gadolinium-based contrast agents may cause false-negative results in assessment of vesicoureteral reflux in children
verfasst von: Simon Veldhoen
Alexander Sauer
Tobias Gassenmaier
Bernhard Petritsch
Stefan Herz
Philipp Blanke
Thorsten Derlin
Thorsten A. Bley
Clemens Wirth
Publikationsdatum: 01.06.2015
Verlag: Springer Berlin Heidelberg
Erschienen in: Pediatric Radiology / Ausgabe 6/2015
Print ISSN: 0301-0449
Elektronische ISSN: 1432-1998
DOI: https://doi.org/10.1007/s00247-014-3243-2

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Contrast-enhanced voiding urosonography phantom study: intravenous iodinated and gadolinium-based contrast agents may cause false-negative results in assessment of vesicoureteral reflux in children