I have not started using CEUS, how can I get started?
What syringe size should I use for injection?
How should I inject contrast?
How should I measure observation size? 


FAQ-151: I have not started using CEUS, how can I get started?


Please see the CEUS Manual for details. 

Also, please check the following websites, which have excellent educational materials and/or links to educational programs and activities: 

 

EFSUMB = European Federation of Societies for Ultrasound in Medicine and Biology

ICUS = International Contrast Ultrasound Society


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FAQ-152: What syringe size should I use for injection?


For Definity: use a 1mL syringe. 

For Lumason/SonoVue: use the supplied 5mL syringe. 


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FAQ-153: How should I inject contrast?

  

Contrast should be injected manually over 2-3 seconds, maintaining steady hand pressure to prevent excess bubble destruction during delivery. The contrast bolus should be followed immediately by a 5-10 mL normal saline flush delivered at approximately 2 mL/sec. 


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FAQ-154: How should I measure observation size? 


 

Step 1 

Acquire images in the appropriate plane – i.e., along the observation’s longest axis. If CEUS is performed for follow up of a previously detected observation, replicate the prior imaging plane using anatomic landmarks (e.g., portal and hepatic veins, gallbladder, falciform ligament) for orientation.


Step 2 

Measure the observation’s outer-to-outer edge dimension along its longest axis, using precontrast B-mode images if possible. If the margins are not clear on precontrast B-mode images, choose the CEUS image on which the margins are most clearly defined, avoiding the peak of arterial phase enhancement if possible. To evaluate size change between exams, select images on each exam acquired in the same plane and temporal phase.


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