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World J Hepatol. Jan 27, 2010; 2(1): 8-15
Published online Jan 27, 2010. doi: 10.4254/wjh.v2.i1.8
Role of contrast enhanced ultrasonography in the assessment of hepatic metastases: A review
Lars Peter Skovgaard Larsen
Lars Peter Skovgaard Larsen, Department of Radiology, Aarhus University Hospital, Noerrebrogade 44, Aarhus 8000 C, Denmark
Author contribution: Larsen LPS contributed solely to this paper.
Correspondence to: Lars Peter Skovgaard Larsen, MD, Department of Radiology, Aarhus University Hospital, Noerrebrogade 44, Aarhus 8000 C, Denmark.
Telephone: +45-89492499 Fax: +45-89492500
Received: August 12, 2009
Revised: September 17, 2009
Accepted: September 24, 2009
Published online: January 27, 2010

Contrast enhanced ultrasonography (CEUS) has improved both the detection and characterization of focal liver lesions. It is now possible to evaluate in real time the perfusion of focal liver lesions in the arterial, portal and late contrast phases, and thus to characterize focal liver lesions with high diagnostic accuracy. As a result, CEUS has taken a central diagnostic role in the evaluation of focal liver lesions that are indeterminate upon computed tomography (CT) and magnetic resonance imaging. The combined use of second generation contrast agents and low mechanical index techniques is essential for the detection of liver metastases, and it now allows the examination of the entire liver in both the portal and late phases. Several studies have shown that using CEUS instead of conventional ultrasonography without contrast agents significantly improves sensitivity in detection of liver metastases. Furthermore, the detection rate with CEUS seems to be similar to that of CT. This review describes the clinical role of CEUS in detecting liver metastases, including details about examination techniques, features of metastases observed with CEUS, and clinical results and guidelines.

Keywords: Ultrasound, Contrast-enhanced ultrasound, Liver neoplasms, Metastasis, Ultrasound contrast agent