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Copyright ©2009 Baishideng Publishing Group Co.
World J Radiol. Dec 31, 2009; 1(1): 25-36
Published online Dec 31, 2009. doi: 10.4329/wjr.v1.i1.25
Table 1 Characteristics of common ultrasound contrast agents used in liver imaging
AgentManufacturerResonance range (MHz)Chemical compositionMI level
Levovist®Schering2-3LipidHigh > 0.6
Air (galactose-based)
Definity®BMS1.5-4LiposomeLow < 0.4
SonoVue®Bracco1.8-3.2PhospholipidLow < 0.4
Sulfur hexafluoride
Sonazoid®GE healthcare2-8LipidLow < 0.4
Table 2 Different phases of liver in contrast-enhanced ultrasound
Arterial phase (s)10-2020-35
Portal venous phase (s)30-45120-180
Late phase (s)120-180240-360
Post-vascular or Kupffer phaseApproximately 10 minAt least 60 min
Table 3 Summary of contrast-enhanced ultrasound findings of common focal liver lesions[72]
ArterialPortalLate vascular phaseParenchymal phase
Malignant focal liver lesions
Hepatocellular carcinomaHyperechoicIsoechoicHypo- or isoechoic (30%)Hypoechoic
MetastasesHypo- or hyperechoic (hypervascular)Hypoechoic with or without rim enhancementHypoechoicHypoechoic
CholangiocarcinomaHypo- or hyperechoic (15%)Iso- or hypoechoicHypoechoicHypoechoic
Benign focal liver lesions
Regenerating nodulesIso- or hypoechoicIsoechoicIsoechoicIsoechoic
Dysplastic nodulesHyper, iso- or hypoechoicIsoechoicHypo- or isoechoicHypo- or isoechoic
HemangiomasHyperechoic (peripheral nodular enhancement)Centripetal fillingIsoechoic if filling is complete (intralesional hypoechoic areas in 50%)Isoechoic (intralesional hypo-echoic areas in 50%)
Homogenous hyperechoic in 20% of small hemangiomasHyper- or isoechoicHyper- or isoechoicIsoechoic
Focal nodular hyperplasiaHyperechoicHyper- or isoechoic; non-enhancing central scar in 45%Hyper- or isoechoic; non-enhancing central scar in 45%Hyper- or isoechoic
Hepatocellular adenomaHyperechoicIsoechoicIsoechoicIsoechoic
Fatty changes or focal fatty sparingIsoechoicIsoechoicIsoechoicIsoechoic
Noncomplicated cystsAbsence of enhancementAbsence of enhancementAbsence of enhancementAbsence of enhancement