On conventional B-mode US the liver lesion could be barely discerned as a slightly hypoechogenic mass.
After IV contrast agent administration (SonoVue) in the early arterial phase, it demonstrated an early hyperenhancement following a spoke wheel pattern (due to the large size of the cine recording only the early arterial phase is shown).
During the late portal and sinusoidal phase, the lesion is still mildly hyperenhancing, while the nonenhancing central scar is best appreciated in this phase. It is worth mentioning that the central scar is also technically hypoenhancing in the arterial phase, though in practice the blooming artifact caused by the presence of concentrated microbubbles the adjacent tissues commonly obscures it.