Purpose or Case Report: Contrast enhanced voiding urosonography (ceVUS) is a radiation free, highly sensitive imaging modality for vesicoureteral reflux (VUR) detection and urethral imaging in children. CeVUS uses ultrasound (US) technology and an US contrast agent (UCA) that is instilled in the bladder via a catheter. This educational exhibit provides step-by-step instructions of our institutional protocol for performing ceVUS exams.

Methods & Materials: Reconstitute the UCA per the manufacturer’s instructions. Prepare a contrast-saline solution in a saline bag adequate to fill the child’s bladder. After mixing, connect tubing and allow the solution to displace the air in the tubing. Complete grayscale images of kidneys and bladder. After the bladder catheter is placed, perform pre-contrast grayscale and contrast mode images. Connect 3-way stopcock to urinary catheter with a saline syringe at the 90-degree port of stopcock and contrast solution at the 180-degree port. Instill saline and contrast-saline solution into the bladder with contiguous imaging of the bladder and each kidney prior to and following voiding. During voiding, the urethra is directly visualized.
Results: By selecting the appropriate transducer, optimizing the image and contrast agent dose, VUR and urethral pathology can be accurately depicted.



Conclusions: ceVUS is non-radiating, real time imaging that is easily performed by following the above described procedural steps.