Contrast-enhanced ultrasound (CEUS) uses intravenous ultrasound contrast agents — microbubble suspensions — to improve lesion characterization and vascular assessment beyond what conventional ultrasound can achieve. Approved microbubble agents (SonoVue/Lumason, Definity) are administered as bolus injections while the sonographer captures arterial, portal venous, and delayed phase enhancement patterns.
Primary applications include liver lesion characterization (differentiating hepatocellular carcinoma from benign lesions like hemangioma and focal nodular hyperplasia), assessment of endoleaks after EVAR (endovascular aortic repair), evaluation of renal and splenic focal lesions, and myocardial perfusion imaging. CEUS offers real-time continuous imaging without radiation and with superior temporal resolution compared to CT or MRI.
CEUS is performed by experienced sonographers holding RDMS (AB) or cardiac credentials who have received specific contrast agent training. It is available at academic medical centers, tertiary hospitals, and CEUS-certified outpatient imaging centers. The technique is expanding in the United States following FDA approval of Lumason for liver applications and GE’s Sonazoid for liver and kidney imaging.