A Study on the Characteristics of Sonazoid Contrast-Enhanced Ultrasound in the Transitional Phase for Common Focal Liver Lesions and Its Value in Differential Diagnosis.

OBJECTIVE

To investigate the value of transitional phase characteristics on Sonazoid contrast-enhanced ultrasound (S-CEUS) in the differential diagnosis of common focal liver lesions (FLLs).

MATERIALS AND

METHODS

This prospective multicenter study enrolled 122 participants with FLLs from 8 medical centers between December 2023 and March 2025. The study comprised 43 cases of hepatic hemangioma (HH), 35 cases of hepatocellular carcinoma (HCC), and 44 cases of liver metastases (LM). All participants underwent standardized S-CEUS examinations. The enhancement characteristics and washout patterns during the transitional phase were analyzed for all participants.

RESULTS

Significant differences were observed among the three types of lesions in terms of early arterial enhancement patterns, time to start of washout, and the degree of enhancement during the transitional phase (P < .01). The optimal diagnostic efficacy was achieved with the following criteria: washout start at 3.5 min for diagnosing HH (AUC = 0.974); mild hypoenhancement observed in 3 and 4 min for diagnosing HCC (AUC = 0.880 and 0.879); and marked hypoenhancement observed between 4 and 6 min for diagnosing LM (AUC = 0.911-0.916).

CONCLUSION

The dynamic characteristics of the transitional phase in S-CEUS can effectively differentiate common FLLs, providing a valuable basis for precise clinical diagnosis.