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Background Focal hepatic lesions incidentally detected during ultrasound usually need further step for proper characterization. The aim of this study was to highlight the efficacy of microbubble contrast-enhanced ultrasonography (CEUS) in characterization of focal liver lesions. This prospective study was conducted on 60 patients presented with hepatic focal lesions in the period from January 2019 to June 2020. CEUS studies were performed after a baseline conventional ultrasound with the same machine by the same operator. The ultrasound contrast agent used is second-generation US contrast agent. The enhancement patterns of the hepatic lesions were studied during the vascular phases up to 5 min and the data were correlated with histopathology, triphasic contrast-enhanced CT, and clinical follow-up. Results CEUS demonstrated a sensitivity of 94.2%, specificity of 88.9%, positive predictive value of 91%, negative predictive value of 94.1%, and accuracy of 92.3% for characterization of hepatic focal lesions, compared to a sensitivity of 100%, specificity of 81.8%, positive predictive value of 84%, negative predictive value of 100%, and accuracy of 90.7% for triphasic CT. Conclusion CEUS is an effective tool in characterization of HFLs and recommended as a second diagnostic step after conventional ultrasound to immediately establish the diagnosis especially in patients with contraindications to CECT.

Characterization of focal liver lesions using sulphur hexafluoride (SF6) microbubble contrast-enhanced ultrasonography