Cystography under ultrasound control (US), also known as Contrast – Enhanced Voiding Urosonography (CEVUS), is a progressive imaging method specifically designed to assess the condition of the bladder and urinary tract in children. This technology is characterized by the absence of ionizing radiation, making it particularly safe and preferable for infants and young children, for whom minimizing radiation exposure is essential.
Main objectives of the study
CEVUS has several key objectives that make it indispensable in pediatric urology and nephrology:
- Exclusion of vesicoureteral reflux (VUR): VUR is a pathological condition where urine is refluxed from the bladder back into the ureters and kidneys. VUR is often the cause of recurrent urinary tract infections in children and can lead to serious complications such as kidney tissue damage and chronic kidney disease. Early detection and treatment of the condition are crucial to prevent these complications.
- Assessment of structural anomalies of the urethra: the urethra is the channel through which urine is expelled from the bladder to the outside. Structural anomalies of the urethra, such as strictures or valves, can obstruct normal urine flow, causing urinary retention and increasing the risk of infections. CEVUS allows for the identification of these anomalies, facilitating timely correction and prevention of complications.
Procedure of the study
The CEVUS procedure is performed by a highly qualified medical team, including a pediatric imaging specialist, an ultrasound technician, and a nurse. If the study is conducted under anesthesia, an anesthesiologist is also part of the team.
The study begins with an ultrasound scan of the kidneys and bladder to obtain baseline images and assess their condition before contrast administration. This stage allows the physician to gather initial data and ensure there are no obvious pathologies.
Next, in sterile conditions, a thin catheter is inserted through the urethra into the bladder. Although this procedure is brief, it may cause discomfort, especially in young children. Therefore, for children over 10 months, the procedure is often performed under anesthesia to minimize stress and pain.
After catheter placement, a contrast agent consisting of microbubbles is introduced into the bladder. These bubbles have a unique ability to reflect ultrasound waves, making them visible on the ultrasound machine screen. The contrast agent helps obtain clear and detailed images, significantly enhancing diagnostic accuracy.
During and after the introduction of the contrast agent, a series of ultrasound scans of the kidneys, ureters, and bladder are performed to assess their condition and identify possible anomalies. This allows the physician to study the anatomy and functional characteristics of the urinary system in detail. At the final stage of the study, a scan is performed after the bladder is emptied and the catheter is removed, allowing assessment of how effectively urine is expelled from the body.
Indications for CEVUS
CEVUS is most commonly indicated in cases of recurrent urinary tract infections or suspected structural disorders of the urinary system. Indications for the study include:
- Recurrent urinary tract infections (UTIs): frequent infections may indicate the presence of VUR or other structural anomalies requiring detailed examination and treatment.
- Suspicion of anatomical anomalies: if a child exhibits symptoms indicating possible structural anomalies of the urinary system, such as difficulty urinating, pain, or unusual urine characteristics, the physician may recommend CEVUS to clarify the diagnosis.
CEVUS is a safe and highly informative diagnostic method that allows physicians to accurately assess the condition of the urinary system in children, exclude or confirm the presence of pathologies, and choose the optimal treatment strategy. This method ensures high diagnostic accuracy and minimizes discomfort for young patients, making it the preferred choice in pediatric practice.
Advantages of the procedure in Israel
- Highly qualified specialists: the Ichilov clinic employs experts with international training and extensive experience in performing CEVUS in children.
- Safety and comfort for children: diagnostic procedures are conducted with minimal discomfort for young patients, often using anesthesia, making them less stressful.
- Absence of ionizing radiation: CEVUS allows for diagnostic studies without radiation exposure, which is especially important for children.
- Comprehensive approach to treatment: the Ichilov clinic offers comprehensive medical care, including follow-up and treatment of identified pathologies, ensuring holistic patient care.
If your child suffers from recurrent urinary tract infections or there are suspicions of structural anomalies in the urinary system, do not delay diagnosis. Contact the Ichilov clinic in Israel to undergo a safe and highly informative CEVUS study.