Purpose or Case Report: ceVUS is a radiation-free and sensitive examination to detect vesicoureteral reflux and image the urethra in children using ultrasound (US) and intravesical administration of an ultrasound contrast agent (UCA). Due to the growing interest to perform ceVUS in children, a urinary bladder phantom was developed to teach the technical aspects of the ceVUS examination. Here we describe the preparation and utility of this reusable phantom as a tool to simulate the UCA administration, distribution and the effect of different US parameters on the UCA appearance in the bladder.
Methods & Materials: A bladder phantom was prepared with materials available at hardware and medical supply stores including a 12-inch latex balloon (bladder), a 6”x6” flexible PVC pipe coupling rubber vessel/tank (body wall), 1-1.5 mm thick silicone material acoustic window, tube connector (bladder catheter), 3-way stopcock, two 150 mL syringes, 1 mL syringe, saline and UCA. The balloon connector, acoustic window, and clamp were created with a 3D printer. An US contrast capable US imaging system and probe imaged the phantom. The rubber tank was filled with a fiber supplement (3 tsp Metamucil) in 10 cups of warm water to mimic the sonographic appearance of body soft tissue. A latex balloon was attached to an internal port of the lid to the tank and lowered into the filled tank. One end of a tube connector was attached to the external port on the tank’s lid, in continuity with the internal port and balloon, and the other end to a 3-way stopcock. A 150 mL syringe containing saline and a 150 mL syringe containing saline and UCA solution were connected to the 90 and 180-degree stopcock ports respectively.
Results: The ceVUS examination was simulated using the Philips EPIQ 7 US scanner with the C9-2 contrast enabled transducer. One operator administered the contrast while the other obtained US images. The US transducer was placed on the phantom’s acoustic window coupled with US gel. 100 mL of saline was injected into the balloon followed by 2.5-5 mL of contrast-saline mixture (150 mL saline and 0.05 mL UCA). Gray scale and contrast specific US settings were adjusted for optimal contrast appearance and to instruct on their function. The flash button was used to destroy the contrast microbubbles between demonstrations. The balloon was easily removed and the rubber tank washed after use.
Conclusions: This bladder phantom was inexpensive, easy to prepare, durable, reusable and served as a versatile teaching tool to demonstrate and practice ceVUS.