Contrast-enhanced ultrasound of benign and malignant liver lesions in children

Cheng Fang, Sudha A. Anupindi, Susan J. Back, Doris Franke, Thomas G. Green, Zoltan Harkanyi, Jörg Jüngert, Jeannie K. Kwon, Harriet J. Paltiel, Judy H. Squires, Vassil N. Zefov, M. Beth McCarville

Research output: Contribution to journalReview articlepeer-review

4 Scopus citations


Contrast-enhanced ultrasound (CEUS) is increasingly being used in children. One of the most common referrals for CEUS performance is characterization of indeterminate focal liver lesions and follow-up of known liver lesions. In this setting, CEUS is performed with intravenous administration of ultrasound contrast agents (UCAs). When injected into a vein, UCA microbubbles remain confined within the vascular network until they dissipate. Therefore, visualization of UCA within the tissues and lesions corresponds to true blood flow. CEUS enables continuous, real-time observation of the enhancement pattern of a focal liver lesion, allowing in most cases for a definite diagnosis and obviating the need for further cross-sectional imaging or other interventional procedures. The recent approval of Lumason (Bracco Diagnostics, Monroe Township, NJ) for pediatric liver CEUS applications has spurred the widespread use of CEUS. In this review article we describe the role of CEUS in pediatric liver applications, focusing on the examination technique and interpretation of main imaging findings of the most commonly encountered benign and malignant focal liver lesions. We also compare the diagnostic performance of CEUS with other imaging modalities for accurate characterization of focal liver lesions.

Original languageEnglish (US)
Pages (from-to)2181-2197
Number of pages17
JournalPediatric radiology
Issue number12
StatePublished - Nov 2021


  • Benign
  • Children
  • Contrast-enhanced ultrasound
  • Lesion
  • Liver
  • Malignant
  • Ultrasound
  • Ultrasound contrast agents

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Radiology Nuclear Medicine and imaging


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