- To provide tips and tricks for obtaining a voiding study of the urethra with high image quality in nearly 100% of patients. - To reaffirm the ease of observing the morphology and function of the urethra by urosonography.

Serial voiding urosonography (VUS) is a dynamic test that consists of the evaluation of the urinary tract by introducing an ultrasound contrast agent into the bladder. At first, VUS was indicated only for the study of vesicoureteral reflux (VUR) in girls or for the follow-up of VUR in both sexes, because it was thought that VUS did not allow for the correct evaluation of the male urethra. A few years later, in part due to technological advances, it was demonstrated that the urethra was not...

PREPARATION Requirements for the technique Material a. High-end ultrasound scanner with dedicated software for contrast-enhanced studies. With second-generation contrast agents it is recommended to use a particular harmonic imaging mode based on pulse inversion with a low mechanical index (MI) (0.09-0.16). This software also enables color coding of the conventional B-mode signal to improve image resolution and enable dual image display (basic image and harmonic image)on a single screenFig. 1. The harmonic images make it easier to perform the procedure, because a single probe can...

Using these tricks and tips for VUS, it possible to obtain better results for imaging studies of the urethra than what has been reported for VCUG. These improvements result from the technique itself, which makes it possible to work in a radiation-free environment that is more comfortable and allows us to get closer to patients (allowing us to interact with them more to distract them with toys, for example), which in turn facilitates cooperation during the test. On the other hand, this VUS protocol lets...

Carmina Duran MD. Department of Radiology. Pediatric Radiology Service. UDIAT-SDI diagnostic center. Institut Universitari Parc Taulí-UAB, Corporació Parc Taulí. Sabadell, Barcelona, Spain. E-mail: [email protected]

F. Piscaglia, et al.The EFSUMB Guidelines and Recommendations on the Clinical Practice of Contrast Enhanced Ultrasound (CEUS): Update 2011 on non-hepatic applications.Ultraschall in Med 2012; 33: 33–59. Schaerffer AJ, Sood S, Logvinenko T, et al. variation in the documentation of findings in pediatric voiding cystourethrogram. Pediatr Radiol2014 Dec;44(12):1548-56. Riccabona M, Vivier PH, Ntoulia A, Darge K, Avni F, Papadopoulou F, et al. ESPR uroradiology task force imaging recommendations in paediatric uroradiology, part VII: standardised terminology, impact of existing recommendations, and update on contrast-enhanced ultrasound of...