Differentiating malignant and benign focal liver lesions in children using CEUS LI-RADS combined with serum alpha-fetoprotein

Figure 3 LR-4 nodule in a 19-hour-old newborn. A: An inhomogeneous hyperechoic nodule measuring 7.2-cm (arrow) in the left lobe of the liver was shown at conventional gray-scale US; B: The lesion was inhomogeneously hyperenhanced (arrow) with large area of unenhancement in the arterial phase (15 s) at contrast-enhanced US; C: The enhanced area of the lesion was seen slightly hyperenhanced (arrow) in the portal phase (89 s); D: The enhanced area of the lesion was seen iso-enhanced (arrow) in the late phase (181 s). There were patchy areas of nonenhancement within the lesion during the whole process. The serum AFP level was greater than 1210 ng/mL. Infantile hemangioendothelioma was confirmed at histopathologic analysis.