Ultrasound imaging of focal liver lesions with contrast agents: which clinical applications?

The contrast-enhanced ultrasonography is a promising technique for the diagnosis of focal liver lesion with an increased sensitivity for the tumour detection and a direct visualization of the tumour vascularity. The future applications of this technique will probably depend on the clinical context: in case of suspicion of benign tumour, contrast injection should be able to facilitate the characterization of hemangiomas and focal nodular hyperplasia, when hepatic metastases are researched, it may improve the detection of small lesions in cirrhotic patients, it may facilitate the detection of small hepatocellular carcinomas and find a place in the systematic screening for these tumours. The recently published data are encouraging, but a confirmation of the clinical interest of this technique, and its place within the imaging diagnostic strategies still have to be performed.