• Tobias Kummer, Laura Oh, Mary Beth Phelan, Robert D Huang, Jason T Nomura, and Srikar Adhikari.
• Department of Emergency Medicine, Mayo Clinic, Rochester, MN, United States. Electronic address: kummer.tobias@mayo.edu.
• Am J Emerg Med. 2018 Jul 1; 36 (7): 1287-1294.

IntroductionContrast-enhanced ultrasound (CEUS) using intravascular microbubbles has potential to revolutionize point-of-care ultrasonography by expanding the use of ultrasonography into clinical scenarios previously reserved for computed tomography (CT), magnetic resonance imaging, or angiography.MethodsWe performed a literature search and report clinical experience to provide an introduction to CEUS and describe its current applications for point-of-care indications.ResultsThe uses of CEUS include several applications highly relevant for emergency medicine, such as solid-organ injuries, actively bleeding hematomas, or abdominal aortic aneurysms. Compared with CT as the preeminent advanced imaging modality in the emergency department, CEUS is low cost, radiation sparing, repeatable, and readily available. It does not require sedation, preprocedural laboratory assessment, or transportation to the radiology suite.ConclusionsCEUS is a promising imaging technique for point-of-care applications in pediatric and adult patients and can be applied for patients with allergy to CT contrast medium or with impaired renal function. More high-quality CEUS research focusing on accuracy, patient safety, health care costs, and throughput times is needed to validate its use in emergency and critical care settings.Copyright © 2018 Elsevier Inc. All rights reserved.

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