The era of the real time low mechanical index (MI) contrast enhanced ultrasound (CEUS) began in 2004. Since then, CEUS with second generation contrast agents like SonoVue has been able to offer a new clinical utility both in diagnosis and in interventional therapies. Intracavitary administration of SonoVue is an off-label, extravascular application of CEUS. There are two distinct applications in gastroenterology that are currently emerging: contrast agent injection into physiological cavities and injection into non-physiological cavities and fistulas. Numerous reports on the extravascular or intracavitary administration of SonoVue have been published and the results are positive, even though larger prospective studies are still lacking.
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