When the doctor tells you to have an ultrasound scan, it's a very familiar thing to us now. But sometimes when he says "I need to do an ultrasound scan with contrast," you get a little scared and curious, don't you? What is "contrast"? Will it cause any harm? Why is a regular scan not enough? Today, we will talk about the answers to all these questions in your mind in a very simple way in this article.
Simply put, what is Contrast-Enhanced Ultrasound (CEUS)?
To understand this, let's first remember what an ultrasound scan is. An ultrasound scan involves sending high-frequency sound waves that we cannot hear into the body, and the waves bounce off the organs inside and create an image on a computer screen.
Contrast-Enhanced Ultrasound (CEUS) is a slightly more advanced version of this procedure. Here, a special liquid is injected into your vein through a small cannula (IV line). This is what we call "contrast." This liquid contains millions of air bubbles, smaller than your blood cells. These are called ``microbubbles'' to be precise.
As these bubbles travel through your blood vessels to various organs, when the sound waves from the ultrasound machine hit these bubbles, they vibrate loudly, bouncing the sound waves back with great force. As a result, the areas with this contrast appear much brighter and clearer in the image you see on the computer screen.
Simply put, this contrast acts like shining a small 'torch' on the organs inside the body. This allows the doctor to see the blood flow to the organs very clearly.
What is the main focus of the CEUS test?
Doctors use this test most often to diagnose certain conditions in the liver and kidneys, but it is also used to examine several other organs.
| The examining organ | Recognizable situations |
|---|---|
| Liver | Identification of cancerous and non-cancerous lesions. |
| Kidneys | Diagnosing kidney cancer, cysts, and infections. |
| Other organs | Checking the function and blood supply of organs such as blood vessels, heart, gallbladder, pancreas, spleen, and bladder. |
| Cancer treatment | Monitoring the response of a cancer tumor to therapy. |
What are the advantages of CEUS over other types of scans?
Sometimes doctors use CEUS in conjunction with or as an alternative to tests such as CT scans and MRI scans because it has several unique advantages.
- Safe for the kidneys: The contrast used in a CT scan can sometimes have an effect on the kidneys. Therefore, CEUS is a much safer option for someone with kidney disease or allergies to CT contrast.
- Better for young children: A CT scan uses X-rays. Ultrasound does not use X-rays. Therefore, CEUS is safer for young children, avoiding unnecessary radiation exposure.
How is this test going? How do you feel?
This whole process is very simple. It happens in two parts.
Step 1: Regular Ultrasound Scan
First, the technician will apply a clear gel to your skin and place a handheld device called a transducer over it. During this time, they will locate the exact location of the organ in question and take some basic images. You will not feel any pain during this time, other than a slight tingling sensation.
Step 2: Ultrasound scan with contrast
Then, a doctor or nurse will insert a small cannula (IV) into a vein in your arm or hand and inject the contrast fluid into your body. You may feel a slight stinging sensation when the needle is inserted and your hand may feel cold as the fluid goes in.
Once the contrast has entered the body, the technician will scan again and take images. This is when they can clearly see how the blood is flowing to the organs.
Don't worry! These air bubbles (`microbubbles`) in the contrast don't stay in the body for long. They burst after a while, and then the harmless gas dissolves in the blood and leaves the body when you breathe out.
When the test is over, the gel will be wiped off and the cannula in your arm will be removed. After that, you can go home without any problems.
How should I prepare before the test?
Usually, this doesn't require much preparation. All you need to do is wear comfortable, loose clothing. However, depending on the organ being examined, you may sometimes receive special instructions.
- Fasting: If it is an abdominal test, you will be advised to avoid eating or drinking for a few hours before the test.
- Full bladder: If you are having a bladder test, you may be asked to drink water and come for the test when your bladder is completely full.
The most important thing is to follow the instructions given by your doctor or hospital exactly.
Are there any risks or side effects to this?
First of all, ultrasound technology is a very safe method with no harmful side effects.
However, some people may experience side effects from the contrast fluid. However, this is very rare . These side effects are usually minor. Let's see what they are.
| Side effect level | Possible symptoms |
|---|---|
| Mild side effects (often self-healing) | Headache, nausea, itching or rash on the skin, pain or warmth at the injection site, feeling of heat in the body, chest discomfort, dizziness, strange taste in the mouth. |
| Moderate side effects (Medical treatment may be required) | Severe nausea or vomiting, narrowing of the airways (bronchospasm), swelling of the face, fainting, low blood pressure. |
| Severe side effects (Extremely rare) | Anaphylaxis - This is a very severe allergic reaction that can be life-threatening. However, this is very rare. Medical staff are always prepared to deal with such emergencies. |
According to statistics, minor side effects occur in as few as 5 out of 100 people (5%). Severe reactions occur in less than 1 out of 10,000 people (less than 0.01%). So don't be unduly alarmed by this.
When will I receive the report?
The images obtained from the test are carefully studied by a radiologist and a report is prepared. Then, that report is given to your treating doctor. Finally, your doctor will explain the results of that report to you.
Take-Home Message
- Contrast-Enhanced Ultrasound (CEUS) is an advanced ultrasound scan that uses a special liquid containing tiny air bubbles to clearly see how blood flows through the body's organs.
- This is especially useful for diagnosing liver and kidney diseases. It is a safer alternative to a CT scan for kidney patients and young children.
- This test is very simple. There is no discomfort other than a small cannula being inserted into the arm and the contrast fluid being administered.
- Side effects from contrast fluid are very rare. Don't be alarmed. If you have any allergies, inform your doctor before the test.
- It is very important to follow the instructions given by the hospital or your doctor (e.g. fasting) exactly to get accurate results.
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