Ugnė Kulnickaitė1, Klaudijus Baranauskas1 , Domantas Vingrys2
1Hospital of Lithuanian University of Health Science Kauno Klinikos, Radiology department, Kaunas, Lithuania
2Hospital of Lithuanian University of Health Science Kauno Klinikos, Internal medicine department, Kaunas, Lithuania
Background. Contrast-enhanced ultrasound (CEUS) is a low-risk, low-cost imaging technique that uses dedicated imaging ultrasound sequences and FDA-approved contrast microbubbles. Clear description of the benign foci that are seen in this initial imaging study and their differentiation from other lesions allow doctors to choose an appropriate follow-up diagnostic or treatment strategy.
Aim: to summarize the latest studies and present information on the use of contrast-enhanced ultrasound for the evaluation and characterization of benign focal liver lesions.
Methods. the literature used for this review was selected using the Medline (PubMed), SpringerLink and ScienceDirect databases covering 2015 to 2022 period. The literature research was conducted using predetermined keywords: contrast-enhanced ultrasound, focal liver lesions. Exclusion criteria were applied to articles related to malignant focal liver lesions. 26 publications were analyzed.
Results. In the case of benign lesions, contrast-enhanced ultrasonography is a useful technique for evaluating focal liver lesions and may reduce the need for additional imaging and biopsy. A benign liver lesion with arterial enhancement that becomes isoenhancing or remains hyperenhancing in the portal and late phases is a common finding. Contrast-enhanced ultrasound has a high safety profile, is relatively cheap, does not use ionizing radioation and does not cause nephrotoxicity.
Conclusions. Contrast-enhanced ultrasound is an effective technique for evaluating focal liver lesions and should be used instead of contrast-enhanced computed tomography and contrast-enhanced magnetic resonance imaging tests. Radiologists must be aware of washout, including its definition, subtypes and potential pitfalls in order to make a correct diagnosis.
Keywords: focal liver lesion, contrast-enhanced ultrasound, hemangioma, focal nodular hyperplasia, adenoma.