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Contrast enhanced ultrasound (CEUS) is a diagnostic method that is well established in childhood because of its benefits. This diagnostic method excludes the use of ionizing radiation, is safe, and is a highly sensitive and specific diagnostic method in certain clinical situations. The method uses ultrasound technology (contrast-specific software) in combination with commercially available second-generation ultrasound contrast, which can be administrated intravenously or intracavitary. In intravenous (IV) application of ultrasound contrast agent, this method is most often used to characterize focal liver changes, to monitor the response of solid malignant tumors during chemotherapy, and to diagnose blunt trauma of the abdomen. In intracavitary application of ultrasound contrast agent, the most widely known and most commonly performed is contrast-enhanced voiding urosonography (ce- VUS - Contrast enhanced voiding urosonography), now an established and routine diagnostic method for the diagnosis and determination of vesicoureteral reflux (VUR). Although only the use of second-generation ultrasound contrast for the characterization of focal liver changes and the diagnosis of vesicoureteral reflux have been legalized for childhood use since 2016, the so-called off-label use of this method is much broader and will certainly be recognized in other areas as very reliable and a safe diagnostic method that does not use ionizing radiation. [ABSTRACT FROM AUTHOR]

The aim of this paper is to show videourodynamics combined with contrast-enhanced voiding urosonography, which has been used at our institution for four years now. This method does not use ionizing radiation and is highly sensitive for vesicoureteral refl ux. During examination, we can simultaneously monitor function of the lower urinary tract, the presence and degree of refl ux, intravesical pressure and the volume at which refl ux occurs, all of these being important for planning of treatment and providing prognosis. We analyze the advantages and disadvantages of this method compared to standard x-ray, and describe the technique of examination. [ABSTRACT FROM AUTHOR]