超声造影诊断原发性小肝癌与肝硬化再生结节的价值

目的探讨超声造影诊断原发性小肝癌与肝硬化再生结节的价值。方法将2014年3月至2015年3月本院收治的经手术或肝脏活组织检查等病理明确诊断为肝硬化增生结节的23例患者(32个病灶)和诊断为原发性小肝癌的25例患者(30个病灶)作为研究对象。所有患者均实施超声造影检查,观察患者动脉相、门脉相和实质相的动态造影变化,总结不同性质病变的造影特点。结果原发性小肝癌的内部结节数量较少,多为单发,病灶与正常组织间界限清楚,边缘处较为整齐,回声除小部分不均匀外,其余皆比较均匀,其形状表现为圆形或类圆形。肝硬化结节周边呈现网格状增高趋势,回声细小整齐,结节病灶和正常组织边界清楚,在中间有类似正常肝组织的回声,可见小血管结构。原发性小肝癌和肝硬化再生结节造影后的诊断符合率均显著高于造影前(χ~2=75.8621,P=0.0000);原发性小肝癌的峰值强度显著高于肝硬化再生结节(t=17.3855,P=0.0000),二者造影剂到达时间无显著差异(t=1.6645,P=0.1028);原发性小肝癌组的造影剂达峰时间较肝硬化再生结节组显著缩短(t=2.5549,P=0.0140)。结论超声造影可以提高肝硬化背景下小肝癌和肝硬化再生结节病灶定性诊断符合率,在小肝癌和肝硬化再生结节的鉴别和诊断中具有重要价值,可为临床早期诊断和鉴别提供参考。     

超声造影鉴别肝硬化增生结节与肝细胞癌的价值探讨

目的：探讨超声造影在肝硬化增生结节和肝细胞癌（HCC）鉴别诊断中的应用价值。方法采用Sono Vue实时灰阶超声造影检查27个HCC和30个肝硬化增生结节,造影时记录并观察其动脉相、门脉相和实质相的动态造影变化及时间-强度曲线（TIC）的变化。结果 HCC病灶在CEUS的增强模式主要表现为快进快出（81.5%,22/27）和快进慢出（18.5%,5/27）,DN则呈多样化表现;HCC组超声造影后开始增强时间（11.48＆#177;2.87）s、增强达峰时间（23.27＆#177;7.75）s及峰值强度（PI）减半时间（84.85＆#177;21.93）s显著快于DN组（15.62＆#177;3.43）s、（37.89＆#177;14.99）s和（114.32＆#177;37.75）s,（P＆lt;0.05）,HCC组超声造影后PI（36.07＆#177;9.65）显著高于DN组（26.44＆#177;6.58）,（P＆lt;0.05）。结论 CEUS在HCC与DN的鉴别诊断中具有重要的临床应用价值。     

超声造影鉴别诊断肝脏局灶性病变的价值

目的探讨超声造影对肝脏局灶性病变的临床诊断价值。方法回顾性分析110例肝脏局灶性病变患者的超声造影检查结果,分析造影表现特征,并经手术或穿刺病理结果证实。结果以手术或穿刺病理确诊结果为标准,超声造影检查对良、恶性肝脏局灶性病变的诊断率分别为97.5%、96%,差异无统计学意义(P0.05)。良性病变的增强时间、达峰时间及消退时间均明显晚于恶性病变,差异均具有统计学意义(P0.05)。本组110例肝脏局灶性病变患者超声造影检查诊断出病变114个,表现特征分别为:肝内胆管细胞癌47个,为快进快出特征;肝细胞癌5个,为快进慢出特征;肝转移癌22个,为快进快出特征;肝血管癌20个,为快进快出特征;肝硬化结节7个,为快进快出特征;局灶性脂肪肝8个,为等进等出特征;局灶性结节增生2个,为快进慢出特征;肝脓肿3个,为快进快出特征。结论超声造影对良性和恶性肝脏局灶性病变的鉴别诊断准确率较高,并能清晰反映出不同性质病变的造影增强特征,具有较高的实用价值,值得进一步推广与应用。     

超声造影诊断肝良性局灶性病变的价值研究

目的探讨超声造影下肝良性局灶性病变的影像特征及其应用价值。方法选取66例2013年2月至2015年1月我院收治肝脏良性局灶性病变患者,分析病灶超声造影特征,采用卡方检验对常规超声与超声造影诊断符合率进行统计分析。结果 66例肝良性局灶性病变患者中,肝包虫、肝脓肿、复杂肝囊肿、肝细胞腺瘤、肝脏炎性假瘤、肝脏血管平滑肌脂肪瘤、肝内脂肪沉积不均、肝脏局灶性结节性增生、肝内胆管囊腺瘤以及肝脏孤立性坏死性结节分别占2、14、7、4、11、2、16、8、1、1例;其中肝包虫(2例)、复杂囊肿(7例)和孤立性坏死性结节(1例)患者无增强,肝脏局灶性结节性增生(8例)和肝脏血管平滑肌脂肪瘤(2例)患者分别呈动脉相急速增强、门脉相和延迟相持续增强;肝内脂肪沉积不均(16例)患者表现为等增强;肝细胞腺瘤(4例)动脉相均表现为高增强,其中门脉相低增强占1例,门脉相和延迟相等增强或高增强占3例;肝脏炎性假瘤(11例)中无增强占7例,动脉相分割状增强后迅速退出占2例,动脉相病灶边缘轻度强化、呈低回声延迟相占2例;肝胆内胆管囊腺瘤(1例)实性部分动脉呈高增强,在门脉相和延迟相低增强,三相中央均无增强区;肝脓肿(14例)中呈动脉相不同程度的网格样增强,门脉相等增强或低增强。使用超声造影对肝脏良性局灶性病变进行诊断,诊断符合率(93.94%)明显优于使用常规超声对肝脏良性局灶性病变进行诊断的诊断符合率(62.12%),差异具有统计学意义(P0.001)。结论对肝脏良性局灶性病变患者使用超声造影进行诊断比常规超声诊断更准确,值得临床推广。     

超声造影检查在肝占位性病变诊断中的应用价值

背景:随着超声造影剂及其成像技术的迅速发展,超声造影技术的临床应用日趋成熟,为肝占位性病变的诊断提供了新手段.目的:分析各种不同的肝占位病变在超声造影检查中的表现,探讨其对该类疾病的诊断价值.方法:使用SonoVue造影剂对22例不同类型的肝占位性病变进行超声造影检查,同时以视频影像同步记录造影剂进入肝内血管、肝实质和肝占位性病变的时间和形态的变化.结果:不同类型的肝占位性病变在超声造影检查中显示出不同的动脉相、门静脉相和延迟相的变化.原发性肝癌以造影剂"快进快出"为主要表现;转移性肝癌以延迟相造影剂充盈缺损为主要表现;肝血管瘤以延迟相有显著的造影剂摄取为主要表现;肝脓肿以快速增强持续整个门静脉相和延迟相为主要表现;肝硬化结节则以与肝实质无法区分的同步强化为主要表现.结论:超声造影检查对肝占位性病变的定性诊断明显优于普通超声检查,在显示肿瘤数目,尤其是发现微小病灶方面优于增强CT,提高了超声检查对肝占位性病变的诊断价值.     

超声造影用于肝硬化合并小肝癌的早期诊断价值

目的探讨超声造影用于肝硬化合并小肝癌的早期诊断的价值。方法选取西安医学院第二附属医院住院超声科2014年7月-2015年7月收治的50例肝硬化合并小肝癌患者,对于肝脏占位性病变进行超声造影检查,记录各个病灶造影增强模式,分析造影前后的占位性病变良恶性评分。结果超声造影对于肝硬化合并小肝癌的灵敏度为94.00%(47/50)。中-低分化癌组开始增强时间明显短于透明细胞癌组,开始消退时间明显短于高分化癌组,差异有统计学意义(P0.05)。中-低分化癌组小肝癌动脉期多快速增强,即快进,当肿瘤内造影剂迅速廓清,实质期小肝癌肿瘤内超声回声强度低于正常肝实质,即为快出,本组占65.83%(79/120),穿刺活检经手术确诊78个为中-低分化癌病灶,其余1个为0.95 cm的透明细胞癌。高分化癌组动脉期快速增强,实质期缓慢退出,呈"快进慢出"模式,透明细胞癌组,超声造影呈"慢进慢出"模式。120个小肝癌病灶造影前典型图像较少,仅57.50%(69/120)有疑似或明确恶性诊断,超声造影后评分提高≥2分的病灶为35灶,占29.17%,造影后评价为5分的病灶为103灶,超声造影对小肝癌诊断准确性为85.83%(103/120)。结论超声造影用于肝硬化患者肝内合并多种类型小肝癌的早期诊断有重要价值,造影可提高超声的诊断率,可作为辅助诊断小肝癌的影像学方法,其灵敏度与准确度均较高,安全简便,值得临床上进一步推广应用。     

肝硬化背景下超声造影鉴别诊断肝细胞肝癌和血管瘤的价值分析

目的探究肝硬化背景下肝细胞肝癌与血管瘤超声造影指标的差异性和动态血管模式(dynamic vascular pattern,DVP)曲线特征,为鉴别诊断提供理论依据。方法选取2015年1月至2016年12月于我院接受超声造影检查的肝硬化背景下局灶性病变患者116例,后经病理或临床确诊,其中肝细胞肝癌和肝血管瘤均为58例。现回顾性分析患者影像学资料,采用SonoLiver软件计算时间-强度曲线(time-intensity curve,TIC)各项参数,绘制DVP曲线,比较两种疾病的差异。结果超声造影表现方面,肝细胞肝癌为"快进快出"增强模式为主,具体为延迟相和门脉相减退,动脉相增强,且增强大部分为整体增强;肝血管瘤可表现为4种增强模式,最常见模式为延迟期对比剂无或轻度退出,门脉期向心性充填,动脉期病变周围呈结节样环状强化。TIC参数方面,肝细胞肝癌组上升时间(rise time,RT)、达峰时间(time to peak,TTP)和平均渡越时间(mean transit time,MTT)均短于肝血管瘤组,峰值强度(intensity maxium,IMAX)高于肝血管瘤组,差异均有统计学意义(P0.05)。DVP曲线方面,肝细胞肝癌组主要为正负双向波,肝血管瘤主要为正向波和负向波,两组波形构成差异有统计学意义(P0.05)。结论超声造影可良好地反映肝硬化背景下肝细胞肝癌与肝血管瘤血流灌注的差异,TIC参数与DVP曲线作为新的定性指标,为鉴别诊断提供了更加有力的依据。     

原发性肝Ca和肝局灶性增生结节的超声临床对比分析

目的比较原发性肝Ca和肝局灶性增生结节的临床特点,为临床诊断提供理论依据。方法选取我院收治的25例原发性肝Ca患者以及25例肝局灶性增生结节患者,入选病例均经病理学检查确诊,经患者允许,均给予超声造影检查,做好相关记录。结果原发性肝Ca的造影方式表现为典型的快进快退型,肝局灶性增生的造影方式呈中央向周边逐渐充填,除充盈方式不同外,肝局灶性增生病灶的消退时间显著短于原发性肝Ca（P〈0.05）。结论超声造影检查可有效显示肝局灶性结节增生及原发性肝Ca的充填方式及充填过程,能清除鉴别病变类型,值得在临床上应用并且具有较高的临床诊断价值。     

超声造影对老年肝硬化背景下肝局灶性小病变的诊断价值

目的探讨超声造影对肝硬化合并肝内局灶性小病灶(≤3.0 cm)的诊断价值。方法回顾性分析该院2011年11月至2012年11月间收治入院的30例合并39个肝内局灶性小病灶(≤3.0 cm)肝硬化患者的常规超声和超声造影检查资料。将常规超声和超声造影结果与病理学结果进行对照分析,计算常规超声和超声造影的敏感性、特异性及准确性。结果本研究30例合并39个肝内局灶性小病灶(≤3.0 cm)肝硬化患者均经超声引导下经皮肝穿刺或外科手术后组织学活检确诊,其中良性病变16个(肝海绵状血管瘤8个病灶,肝囊肿3个病灶,肝硬化结节2个病灶,炎性病变2个病灶,局限性脂肪浸润1个病灶),恶性病变23个(原发性肝细胞癌17个病灶,肝脏转移瘤6个病灶)。超声造影敏感性、特异性、阴性预测率分别为91.67%、93.33%、87.50%,常规造影检查敏感性、特异性、阴性预测率分别为77.78%、83.33%、62.50%,超声造影检查结果均明显优于常规超声检查。结论超声造影技术对鉴别肝硬化合并肝内局灶性小病灶(≤3.0 cm)较常规超声具有更好的临床应用价值。     

超声造影对肝脏孤立性坏死结节的诊断价值

目的总结肝脏孤立性坏死结节(SNNL)超声造影所见,进一步探讨超声造影在其诊断及鉴别诊断中的作用。方法回顾性分析2005年4月-2014年5月于中国医科大学附属盛京医院超声造影诊断为SNNL的23例患者25个病灶的超声及造影表现。结果手术切除经病理证实为SNNL者有5例;18例经超声随访或其他影像学(增强CT或增强磁共振成像)证实为坏死结节。25个孤立性坏死结节病灶中,12个病灶内三相均未见造影剂填充呈无增强;13个病灶动脉相病灶周边呈薄环状高增强,门脉相及延迟相与肝实质呈等增强,病灶内部三相均未见造影剂填充。结论病灶整体三相无增强或病灶周边薄环状增强,内部三相无增强是SNNL的特征性超声造影表现,这一特点有益于其他肝脏占位性病变的鉴别。     

Diagnosis of small hepatic nodules detected by surveillance ultrasound in patients with cirrhosis: Comparison between contrast-enhanced ultrasound and contrast-enhanced helical computed tomography.

Aim: To investigate the diagnostic value for the diagnosis of small (1-2 cm) hepatic nodules detected by surveillance ultrasound in patients with cirrhosis using contrast-enhanced ultrasound (CEUS) compared with that of contrast-enhanced helical computed tomography (CECT). Methods: Seventy-two liver cirrhosis patients with 103 small hepatic nodules (1-2 cm) detected by surveillance ultrasound were enrolled in the present study. All patients underwent CEUS with SonoVue as well as CECT. Nodules which appeared by contrast enhancement during the arterial phase and contrast wash-out during the late phase on CEUS or CECT were diagnosed as malignant (hepatocellular carcinoma [HCC]). Histopathology obtained from biopsy or surgery served as the gold standard. Results: According to the above diagnostic criteria, the sensitivity (i.e. rate of correct diagnosis of HCC) was 91.1% (51/56 HCC) for CEUS and the specificity (i.e. the rate of correct exclusion of HCC) was 87.2% (41/47 regenerative nodules [RN]).Therefore, the diagnostic accuracy of CEUS was 89.3% (92/103 all nodules). Using the same diagnostic criteria, the sensitivity, specificity and accuracy of CECT were 80.4% (45/56 HCC), 97.9% (46/47 RN), and 88.4% (91/103 all nodules). Overall, there was no significant difference between CEUS and CECT in the diagnostic confidence of small hepatic nodules. Eighty-six nodules (45 HCC and 41 RN) were correctly diagnosed by both modalities and six (five HCC and one RN) were misdiagnosed by both. Conclusion: The ability of CEUS in the characterization of small nodules (1-2 cm) detected by surveillance US in patients with liver cirrhosis is similar to that of CECT.     

The role of contrast-enhanced ultrasound on the diagnosis of small hepatocellular carcinoma (

Min Hua Chen  Ying Dai  Kun Yan  Zhi Hui Fan  Shan Shan Yin  Wei Yang  Wei Wu  Yan Bin Wang  Ji You Li 《Hepatology research》2006,35(4):281-288

Small hepatic nodules (< or =2 cm) in cirrhosis patients: characterization with contrast-enhanced ultrasonography.

AIM: We evaluated the efficacy of contrast-enhanced ultrasonography (CEUS) for the characterization of small hepatic nodules (< or =2 cm) in cirrhosis patients. PATIENTS AND METHODS: Thirty cirrhosis patients with 30 hepatic nodules (1-2 cm) were enrolled in this study. Eighteen hepatic nodules were hepatocellular carcinomas (HCC) and 12 were benign lesions. CEUS was performed using microbubble contrast (Levovist). With surrounding hepatic parenchyma as a reference, two characteristics of hepatic nodules, including arterial phase enhancement (AE) and the absence of delayed phase enhancement (ADE), were evaluated as criteria for the diagnosis of HCC. A radiologist independently reviewed the dynamic computed tomographies (CT) of 26 hepatic nodules. RESULTS: CEUS showed AE in 15 nodules (13 HCC and two benign) and ADE in 17 lesions (14 HCC and three benign). For HCC, the coincidental AE of both CEUS and dynamic CT was 40%. Using both AE and ADE for HCC diagnosis, the sensitivity, specificity, accuracy, positive predictive value and negative predictive values were 55.6%, 91.7%, 70%, 90.9% and 57.9%, respectively. When using either AE or ADE for HCC diagnosis, the same parameters were 94.4%, 66.7%, 83.3%, 81% and 88.9%, respectively. One benign hepatic nodule with both AE and ADE was diagnosed as HCC 29 months after the CEUS study. CONCLUSIONS: A combination of characteristics of AE and ADE as determined by CEUS was highly specific for small HCCs in cirrhosis patients. Concurrent delayed phase imaging is useful in the diagnosis of small hypovascular HCCs.     

超声造影对诊断早期肝硬化合并小肝癌的价值

目的：了解超声造影对肝硬化合并小肝癌的诊断价值。方法选取2010年5月至2013年6月收治的患者96例,进行超声造影检查,从而评价小肝癌的增强变化,并与动态增强 MRI 以及动态增强CT 进行对比。结果超声造影下的小肝癌表现出动脉期增强,静脉期降低,以增强期或者低增强为标准,最终诊断的正确率为85．4％（82/96）,进一步结合延迟期肝癌的低增强的指标,诊断的正确率达到94．8％（91/96）,假阳性率为5．2％（5/96）。结论超声造影在诊断早期肝硬化合并小肝癌方面有着较为理想的价值。     

Contrast-enhanced ultrasound features of histologically proven small (≤20 mm) liver metastases

Objective: We analyzed contrast-enhanced ultrasound (CEUS) features of histologically proved small (≤20?mm) liver metastases, in comparison to small (≤20?mm) hepatocellular carcinomas (HCC), to define the differentiate diagnoses value of CEUS in clinical practice.

Material and methods: Eighty-two cases of small (≤20?mm) liver metastases and 84 cases of small (≤20?mm) HCC were retrospectively reviewed. All patients had CEUS images. Two radiologists assessed CEUS enhancement pattern and time of enhancement in consensus. Statistical analyses were performed using SPSS v.19.0 (SPSS Inc., Chicago, IL). The χ² test and the independent sample t-test were used to compare the differences.

Results: Comparing to small HCCs, rapid rim-like hyper-enhancement in arterial phase (56.1% in liver metastases vs. 2.3% in HCCs, p?<?.01), rapid wash-out and become hypo-enhancement in late arterial phase or early portal venous phase (96.4% in liver metastases vs. 22.6% in HCCs, p?<?.01) with central non-enhanced area in late phase were characteristic CEUS features of small metastases.

Conclusions: CEUS imaging enhancement findings reliably offer typical signs of small liver metastases, differentiate effectively with small HCCs. CEUS can help to improve the diagnostic confidence of small liver metastases.     

超声造影灌注时相分析在肝硬化背景下对肝脏增生结节的诊断价值

目的 探讨超声造影(CEUS)灌注时相分析在肝硬化背景下对肝脏增生结节的诊断价值.方法 2017年6月～2020年6月我院诊治的肝硬化患者100例,均接受CEUS检查,获得超声造影定量参数,包括造影峰值强度(Peak)、达峰时间(TTP)和平均度越时间(MTT),记录两组局部血容量(RBV)和局部血流量(RBF)水平....     

Contrast-enhanced ultrasound in differentiating malignant from benign portal vein thrombosis in hepatocellular carcinoma

Portal vein thrombosis (PVT) may occur in liver cirrhosis patients. Malignant PVT is a common complication in cirrhotic patients with concomitant hepatocellular carcinoma (HCC) and, in some cases, it may be even the initial sign of an undetected HCC. Detection of malignant PVT in a patient with liver cirrhosis heavily affects the therapeutic strategy. Gray-scale ultrasound (US) is widely unreliable for differentiating benign and malignant thrombi. Although effective for this differential diagnosis, fine-needle biopsy remains an invasive technique. Sensitivity of color-doppler US in detection of malignant thrombi is highly dependent on the size of the thrombus. Contrast-enhanced computed tomography (CT) and contrast-enhanced magnetic resonance (MRI) can be useful to assess the nature of portal thrombus, while limited data are currently available about the role of positron emission tomography (PET) and PET-CT. In contrast with CT, MRI, PET, and PET-CT, contrast-enhanced ultrasound (CEUS) is a fast, effective, well tolerated and cheap technique, that can be performed even in the same session in which the thrombus has been detected. CEUS can be performed bedside and can be available also in transplanted patients. Moreover, CT and MRI only yield a snapshot analysis during contrast diffusion, while CEUS allows for a continuous real-time imaging of the microcirculation that lasts several minutes, so that the whole arterial phase and the late parenchymal phase of the contrast diffusion can be analyzed continuously by real-time US scanning. Continuous real-time monitoring of contrast diffusion entails an easy detection of thrombus maximum enhancement. Moreover, continuous quantitative analyses of enhancement (wash in - wash out studies) by CEUS during contrast diffusion is nowadays available in most CEUS machines, thus giving a more sophisticated and accurate evaluation of the contrast distribution and an increased confidence in diagnosis in difficult cases. In conclusion, CEUS is a very reliable technique with a high intrinsic sensitivity for portal vein patency assessment. More expensive and sophisticated techniques (i.e., CT, MRI, PET, and PET-CT) should only be indicated in undetermined cases at CEUS.     

肝脓肿患者超声造影特点及诊断价值分析

目的 研究肝脓肿患者超声造影(CEUS)检查表现特点及诊断价值。方法 2016年4月～2019年4月我院收治的120例肝脓肿患者,行常规二维超声和CEUS检查,分析其影像学特征,以穿刺治疗结果为金标准,分析CEUS和常规二维超声诊断肝脓肿病灶的一致性。结果 在120例患者中,脓肿炎性期22例,脓肿形成初期42例和脓肿形成期56例;常规二维超声检出107例(89.2%),其中脓肿炎性期和脓肿形成初期影像学表现为不规则或规则病灶,病灶边界不清晰或清晰,病灶内未见液性暗区,可见血流信号,脓肿形成期影像学表现为不规则或规则病灶,病灶边界不清晰或清晰,病灶内见液性暗区,无血流信号;CEUS检出肝脓肿117例(95.0%),其中脓肿炎性期和脓肿形成初期影像学表现为病灶动脉期高增强,门静脉期和延迟期低增强,显示范围较常规超声明显增大,脓肿形成期影像学表现为病灶动脉期高增强,门静脉期和延迟期低增强现象减少,显示范围较常规超声明显增大;CEUS诊断肝脓肿病灶的灵敏度为95.0%,特异度为76.9%,阳性预测值为89.7%,阴性预测值为33.3%,Kappa值为0.88。结论 不同病程的肝脓肿CEUS影像学表现各有特点,其诊断肝脓肿的灵敏度、特异度和准确性均较高,在鉴别诊断有困难时可以考虑应用。     

虚拟导航超声造影与常规超声造影检查肝硬化背景小肝癌的诊断价值比较

目的探讨虚拟导航超声造影与常规超声造影检查肝硬化背景小肝癌的诊断效能。方法 45例肝硬化患者经增强CT/MRI检查提示肝内局灶性结节共计68个,全部病灶均经病理检查确诊,其中小肝癌45个,肝硬化结节(非小肝癌)23个。分别行常规超声造影检查及虚拟导航超声造影检查,计算2种方法的灵敏度、特异度及正确率等指标。结果常规超声造影诊断小肝癌的灵敏度、特异度及正确率依次为60.0%、69.5%和63.2%,虚拟导航超声造影依次为86.6%、78.3%和83.8%。虚拟导航超声造影诊断小肝癌的灵敏度、特异度和正确率高于常规超声造影(P均<0.05)。结论虚拟导航超声造影可检出常规超声造影不易检出的肝硬化结节背景下小肝癌,为临床诊断提供有效支持。     

Ultrasound features of hepatocellular adenoma and the additional value of contrast-enhanced ultrasound

BACKGROUND: Hepatocellular adenoma(HCA) is a rare benign tumor of the liver. It is of clinical importance to differentiate HCA from other liver tumors, especially hepatocellular carcinoma(HCC). This study aimed to evaluate the characteristic features of HCA by conventional ultrasound and contrast-enhanced ultrasound(CEUS) findings.METHODS: Twenty-six patients(10 males and 16 females; mean age 36.2±5.0 years) with 26 histopathologically proven HCAs were retrospectively identified. According to the maximum diameter of HCAs, they were divided into three groups: 30 mm, 30-50 mm, and 50 mm. Ultrasound examinations were performed with C5-2 broadband curved transducer of Philips i U22 unit(Philips Bothell, WA, USA). For each lesion, a dose of 2.4 m L Sono Vue#174;(Bracco Imaging Spa, Milan, Italy) was injected as a quick bolus into the cubital vein. Lesions' echogenicity, color-Doppler flow imaging and contrast enhancement patterns were recorded.RESULTS: Grayscale ultrasound revealed that most of HCAs were hypoechoic(73.1%, 19/26). Spotty calcifications were detected in 26.9%(7/26) of the lesions. Color-Doppler flow imaging detected centripetal bulky color flow in 46.2%(12/26) of the HCAs. CEUS showed that 73.1%(19/26) of the HCAs displayed as rapid, complete and homogenous enhancement, and 53.8%(14/26) showed decreased contrast enhancement in the late phase. There was no significant difference in enhancement patterns among different sizes of HCAs(P0.05). Centripetal enhancement with subcapsular tortuous arteries was common in larger HCAs.CONCLUSIONS: CEUS combined with grayscale and colorDoppler flow imaging helped to improve preoperative diagnosis of HCAs. The characteristic imaging features of HCAs included: rapid homogeneous enhancement and slow washout pattern on CEUS; heterogeneous echogenicity on grayscale ultrasound; and centripetal enhancement with subcapsular tortuous arteries in large HCAs.