Clinical Utility of Contrast-Enhanced Ultrasound (CEUS) in Urology: A Multisystem Review

Contrast-enhanced ultrasound (CEUS) is a non-invasive, versatile imaging technique with an expanding spectrum of uses across a wide variety of urological disorders. By utilizing microbubble-based contrast agents confined to the intravascular space, CEUS provides real-time, high-resolution assessment of tissue vascularity without ionizing radiation or nephrotoxic contrast. This review presents an updated overview of CEUS applications in urology, including renal mass characterization, staging of bladder cancer, assessment of scrotal trauma, fertility interventions such as microdissection testicular sperm extraction (M-TESE), and adjunctive prostate cancer imaging. Despite multiple advantages, the more widespread use of CEUS is limited by its limited availability and the absence of standardized imaging protocols. As evidence becomes increasingly available and consensus guidelines emerge, CEUS will take its place as a fundamental tool in the diagnostic armamentarium of modern urological practice.