[Contrast-enhanced ultrasound (CEUS) of the liver : Critical evaluation of use in clinical routine diagnostics].

CLINICAL/METHODICAL ISSUE: Focal liver lesions are common incidental findings in abdominal ultrasound diagnostics.

STANDARD RADIOLOGICAL METHODS: Characterization of focal liver lesions solely based on b‑mode and color duplex is not feasible in all cases.

METHODICAL INNOVATIONS: Using contrast-enhanced ultrasound (CEUS) it is possible to dynamically visualize the vascularization of focal liver lesions, which enables the characterization of benign and malignant liver tumors. The advantages of CEUS are that ultrasound contrast media do not show renal, hepatic or cardiac toxicity and do not influence the thyroid gland. The approach by fusion of CEUS and contrast-enhanced cross-sectional imaging combines the advantages of both imaging modalities.

PERFORMANCE: Using CEUS focal liver lesions can be characterized with a diagnostic accuracy greater than 90%.

ACHIEVEMENTS: The use of CEUS has become an important imaging modality to evaluate unclear liver lesions.

PRACTICAL RECOMMENDATIONS: The use of CEUS provides vital information as a supplement to cross-sectional imaging and it has become an important tool in therapy planning, control and monitoring of malignant liver lesions.