Contrast enhanced ultrasound (CEUS) is an advanced imaging technique that improves the detail and accuracy of traditional ultrasound scans. It involves the use of a specialised contrast agent that helps doctors visualise blood flow and tissue structures more clearly in real time.
Unlike standard ultrasound, which relies only on sound waves reflecting from tissues, contrast enhanced ultrasound microbubbles injected into the bloodstream. These microbubbles enhance the ultrasound signal and make it easier to assess how blood moves through organs, muscles, and other tissues.
CEUS is increasingly used in diagnostic imaging for tumour characterisation because it provides real-time evaluation of contrast uptake into the region of interest without exposing patients to radiation. Additionally, it may be an alternative to MRI or CT in select patients where MRI is not suitable or if there is a contrast allergy to iodine.
How contrast enhanced ultrasound works
During a contrast enhanced ultrasound examination, a small amount of contrast agent containing microbubbles is injected into a vein, usually in the arm. These microbubbles circulate through the bloodstream and reflect ultrasound waves more strongly than surrounding tissues.
Because the microbubbles remain within the blood vessels, CEUS allows sonographers and radiologists, to see blood flow patterns in real time.
Common uses of contrast enhanced ultrasound
Contrast enhanced ultrasound is used in several areas of medicine. It is commonly used to assess organs such as the liver, kidneys, and pancreas, where it can help detect lesions or evaluate blood supply to tissues. In fact, contrast-enhanced ultrasound may be an alternative imaging technique for monitoring liver or kidney conditions where 3T MRI is not suitable.
In musculoskeletal medicine, CEUS may be used to evaluate tissue vascularity, inflammation, and healing responses in muscles, tendons, or joints. This can help guide treatment planning and monitor how tissues respond to certain therapies.
CEUS is also used in interventional procedures, where it can help clinicians visualise structures more clearly during image-guided treatments. See our latest publication using CEUS for guidance of PRP into the hip joint, where needle placement can be difficult to see on traditional ultrasound.
How to prepare for a contrast-enhanced ultrasound
Preparation for a contrast enhanced ultrasound is usually simple. In many cases, no special preparation is required. For some abdominal scans, you may be asked to fast for a few hours beforehand to help improve image quality.
You can usually continue taking your regular medications unless advised otherwise. A small intravenous line may be placed in your arm so the contrast microbubbles can be injected during the scan.
The procedure is generally quick, and most patients can return to normal activities immediately afterwards.
How much does contrast-enhanced ultrasound cost in Australia?
The ultrasound scan itself may be partially covered by the Medicare Benefit Scheme for a Medicare Card holder with a valid referral. However, there may be out-of-pocket expenses related to the use of ultrasound contrast medium. Please contact MBR Health to learn more about the expected costs.
Book Your Contrast Enhanced Ultrasound in the Gold Coast
If you have a Doctors referral, MBR Health offers advanced Contrast Enhanced Ultrasound performed by an industry-leading expert sonographer in the Gold Coast area. Contact our friendly reception team for more information, cost and availability.
If you would like to read more on a recently published case study please visit our publications page.
Frequently Asked Questions about Contrast Enhanced Ultrasound
Below are some commonly asked questions about contrast enhanced ultrasound. For more Frequently Asked Questions, visit our FAQ page.
What are the advantages of CEUS compared with CT or MRI?
Contrast enhanced ultrasound does not use radiation and can provide real-time imaging of blood flow. It is also quick, well tolerated, and can often be performed during a routine ultrasound appointment.
Are the microbubbles used in contrast enhanced ultrasound safe?
Yes. The microbubbles used in contrast enhanced ultrasound are specifically designed to be safe for medical imaging. They are extremely small—about the size of red blood cells—so they can move easily through the body’s smallest blood vessels without blocking blood flow.
These microbubbles are not simply air. They contain a specialised gas enclosed in a stabilising shell made of lipids that keeps them intact long enough for imaging. Only a very small amount is injected during the scan.
After the procedure, the gas dissolves in the bloodstream and is naturally removed from the body through the lungs when you breathe out. The outer lipid shell is then broken down by the body.
Importantly, these microbubbles do not cause aneurysms or air embolisms. When used in medical imaging by trained professionals, contrast enhanced ultrasound has been shown to be safe and well tolerated.
How long does a CEUS scan take?
Most contrast enhanced ultrasound scans take around 20–30 minutes. The contrast injection itself only takes a few seconds, while the imaging is performed in real time as the microbubbles circulate.
Author: Dr A Forbes (PhD)
Reviewer: Bryce Allen (Chief Sonographer, MBR Health)
