Purpose or Case Report: Contrast enhanced ultrasound is a radiation free, highly sensitive imaging modality for detection of focal liver lesions in children. CEUS uses ultrasound (US) technology and an US contrast agent (UCA) that is administered intravenously. This educational exhibit provides step-by-step instructions of our institutional protocol for performing CEUS exams.
Methods & Materials: Complete grayscale images of liver. A 22-24g intravenous (IV) catheter is ideally placed in left peripheral. After the IV is placed, perform pre-contrast grayscale and contrast mode images. Reconstitute the UCA per the manufacturer’s instructions. Connect 3-way stopcock to IV catheter with a saline syringe at the 90-degree port of stopcock and contrast at the 180-degree port. Inject contrast into the IV immediately followed by saline flush. Perform contiguous imaging of the liver during the arterial, portal venous and late parenchymal phases.
Results: By selecting the appropriate transducer, optimizing the image and contrast agent dose, liver pathology can be accurately depicted.

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