As with any other CEUS exam the lesion was first confirmed and measured and the entire liver was scanned using B-mode US.
After the injection of IV contrast (SonoVue) the lesion demonstrated marked hyperenhancement during the entire arterial phase (see cine loop), while it remained isointense throughout the portal and sinusoidal phases. Most importantly no washout could be observed. Altogether the findings are characteristic for a flash-filling hemangioma, and do not support malignancy. Prior oncological control CT exams were performed with only venous phase acquisitions to limit radiation dose, which offers an explanation why the lesion remained undetected. Further regular follow-up of the patient is nevertheless warranted.
The geographical low echogenicity areas remained isointense through the entire exam (not shown) in line with focal fatty sparing.