Focal hepatic lesions: Evaluation with contrast-enhanced gray-scale harmonic US

Hyun Jung Jang, Hyo K. Lim, Won Jae Lee, Seong Hyun Kim, Min Ju Kim, Dongil Choi, Soon Jin Lee, Jae Hoon Lim

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20 Citations (Scopus)


Objective: To determine the findings of various focal hepatic lesions at contrast-enhanced gray-scale ultrasound (US) using a coded harmonic angio (CHA) technique and emphasizing lesion characterization. Materials and Methods: The study involved 95 patients with 105 focal hepatic lesions, namely 51 hepatocellular carcinomas (HCCs), 22 metastases, 22 hemangiomas, four cases of focal nodular hyperplasia (FNH), and six nontumorous nodules. After the injection of a microbubble contrast agent (SH U 508A), gray-scale harmonic US studies using a CHA technique were performed with a combination of continuous scanning to assess the intratumoral vasculature (vascular imaging) and interval-delay scanning to determine the sequential enhancement pattern (acoustic emission imaging). Each imaging pattern was categorized and analyzed. Results: At vascular imaging, 69% of HCCs (35/51) showed irregular branching vessels, while in 91% of metastases (20/22) a peripherally stippled pattern was observed. Intratumoral vessels were absent in 95% of hemangiomas (21/22) and all nontumorous lesions (6/6), while in 75% of FNHs (3/4) a spoke-wheel pattern was evident. At acoustic emission imaging, 71% of HCCs (36/51) showed heterogeneous enhancement and 86% (19/22) of metastases showed rim- or flame-like peripheral enhancement during the early phase, with washout occurring in all HCCs and metastases (100%, 73/73) during the late phase. In hemangiomas, enhancement was either peripheral and nodular (19/22, 86%) or persistent and homogeneous (3/22, 14%), and 75% of FNHs (3/4) became isoechoic during the late phase. Conclusion: At contrast-enhanced gray-scale US using a CHA technique, a period of continuous scanning depicted the intratumoral vasculature, and interval-delay scanning demonstrated the sequential enhancement pattern. The characteristic findings of various focal hepatic lesions were thus determined.

Original languageEnglish
Pages (from-to)91-100
Number of pages10
JournalKorean journal of radiology
Issue number2
Publication statusPublished - 2003
Externally publishedYes


  • Liver neoplasms, US
  • Ultrasound (US), contrast media
  • Ultrasound, harmonic study
  • Ultrasound, technology

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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