Analysis of focal inflammatory lesions of the liver with contrast-enhanced ultrasound

Objective To investigate the features of focal inflammatory lesions of the liver with contrast-enhanced ultrasound (CEUS) and improve the accuracy of diagnosis. Methods Conventional ultrasonography and CEUS were performed in twelve patients with histologically proven focal inflammatory lesions of the liver (including liver abscess in 5, hepatic inflammatory pseudotumor in 4 and hepatic tuberculosis in 3). The features of conventional ultrasonography and enhancement patterns of the lesions were analyzed. Results Focal inflammatory lesions of the liver were hypoechoic lesions (11/12) with vague margin (8/12) in conventional ultrasonography. Arterial blood signal can be detected in the lesions (6/12).The lesions of liver abscess in 5 cases had different enhancement features due to the lesions in different stages, however, transient segmental enhancement of arterial phase was observed in 3 cases in liver parenchyma adjacent to the lesions. The lesions of inflammatory pseudotumor in 4 cases showed a rapid wash-in and rapid washout contrast enhancement pattern, however, the lesions were slightly hyperechoic and ill-defined in arterial phase without space-occupying effect. The lesions of hepatic tuberculosis in 3 cases only showed peripheral globular-nodular or peripheral rim enhancement and center part of the lesions were lack of enhancement during CEUS. Conclusions Though focal inflammatory lesions of the liver had multiple contrast enhancement patterns, each type of focal inflammatory lesions had some enhancement features that could depict their pathologic changes in different stages. CEUS helped to improve the accuracy of diagnosis.