CEUS for Liver Tumors

CEUS for Liver Tumors

CEUS for Liver Tumors 0%

1. Introduction to CEUS

Principles of Contrast-Enhanced Ultrasound
Microbubble Contrast Agents (e.g., SonoVue, Definity)
Advantages Over CT/MRI in Liver Imaging
Safety Profile and Contraindications

2. CEUS Phases and Timing

Arterial Phase (10–35 sec)
Portal Venous Phase (30–120 sec)
Late Phase (>2 min)
Wash-in and Wash-out Patterns

3. CEUS in Benign Liver Lesions

Hemangioma: Peripheral Nodular Enhancement
Focal Nodular Hyperplasia (FNH): Central Arterial Fill-in
Hepatic Adenoma: Homogeneous Hyperenhancement
Cyst: No Enhancement

4. CEUS in Malignant Liver Lesions

Hepatocellular Carcinoma (HCC): Arterial Hyperenhancement with Late Washout
Cholangiocarcinoma: Rim Enhancement, Delayed Washout
Liver Metastases: Rapid Washout in Portal Phase
Angiosarcoma: Early Hyperenhancement + Irregular Washout

5. Comparison with Other Modalities

CEUS vs CT for HCC Diagnosis
CEUS in Indeterminate Lesions (LR-3, LR-4 in LI-RADS)
Role in Guiding Biopsies or Ablations

6. Limitations and Pitfalls

Isoenhancing Lesions
Deep or Subdiaphragmatic Lesions
Artifacts: Blooming, Motion
Learning Curve for Interpretation

7. Case Examples and Interpretation

CEUS Pattern Recognition (Benign vs Malignant)
CEUS for Follow-up Post-Treatment (RFA, TACE)
Multiple Case Snapshots with Key Features

8. Quiz and Self-Assessment

Phase Identification Challenge
Spot the Pattern: HCC vs Metastasis
CEUS Diagnosis-Based MCQs