Conclusion
Until recently, US was the preferred screening method for focal liver lesion disease because of the inherent advantages; however, it suffered a relatively poor sensitivity and specificity rate compared with other imaging techniques, such as CT and MRI, and further imaging was often required for a definitive diagnosis.
Since the advent of US contrast agents and new contrast-specific US techniques, US of the liver has improved dramatically. Detection of metastases is markedly improved as is lesion characterisation. The detection of liver metastases using CEUS is similar to spiral CT. The ability of contrast US to characterise focal liver lesions is superior to that of CT and at least equivalent to that of MRI. On the other hand, some limitations of US remain, such as its operator dependence or the limited access to certain parts of the liver especially in obese patients and/or fatty livers.
CEUS is a young field in which unexpected progress has been made in the last few years and is now at a stage where it is ready for routine clinical use. It adds a new dimension to liver US. We would like to encourage all radiologists and sonographers to start using it, since it provides crucial diagnostic information that is completely occult in conventional sonography, allowing it to rival CT and MRI.
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Albrecht, T., Oldenburg, A., Hohmann, J. et al. Imaging of liver metastases with contrast-specific low-MI real-time ultrasound and sonoVue. Eur Radiol 13 (Suppl 3), N79–N86 (2003). https://doi.org/10.1007/s00330-003-0012-2
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DOI: https://doi.org/10.1007/s00330-003-0012-2