Real-time imaging with the sonographic contrast agent SonoVue:differentcation of benign and malignaut hypoechoic focal lesions in fatty liver

Objective:We use real-time contrast-enhanced ultrasound(CEUS)technique with the sonographic contrast agent SonoVue to diagnosis between benign and malignant hypoechoic focal lesions in fatty liver.Methods:We studied 41 hypoechoic liver lesions(in 33 patients) found on conventional grayscale sonography with contrat-enhanced ultrasonography.Final diagnosis was made using contrast enhanced helical CT,contrast enhanced MR,and histopathic confirmation or clinical imaging follow-up.Results:There were 7 malignant lesions demonstrated:2 hepatocellular carcinomas,3 metastatic carcinomas,1 cholangiocellular carcinomas and 1 non-hodgkin′s 1ymphoma.34 benign lesions demonstrated:11 hemangiomas,5 focal nodular hyperplasias(FNH),18 focal areas of sparing in hepatic steatosis.CEUS characterized 33/34 benign lesions and 7/7 malignant lesions.Conclusion:CEUS with SonoVue contrast agent can distinguish malignant from benign hypoechoic lesions in fatty liver.