71-year-old woman at high-risk for HCC due to chronic hepatitis B. Patient underwent CEUS using perfluorobutane. (IMAGE)

American Roentgen Ray Society

71-year-old woman at high-risk for HCC due to chronic hepatitis B. Patient underwent CEUS using perfluorobutane.

Caption

(A) Arterial-phase CEUS image (12 seconds after injection) shows 25-mm segment-8 lesion with nonrim hyperenhancement (arrow). (B) CEUS image in portal-venous phase (48 seconds) shows corresponding early washout (arrow). (C) CEUS image in late phase (2 minutes) shows corresponding late and mild washout (arrow). (D) CEUS image in Kupffer phase (15 minutes) shows marked Kupffer defect (arrow). Patient also underwent evaluation by dynamic contrast-enhanced MRI using gadoxetate disodium. (E) Axial arterial-phase image shows 23-mm segment-8 lesion with nonrim arterial phase hyperenhancement (arrow). (F) Axial portal-venous phase image shows corresponding nonperipheral washout (arrow). Observation was classified as LR-M by modified CEUS criteria using perfluorobutane, and as LR-5 by CT/MRI LI-RADS v2018. Pathologic diagnosis based on surgical resection was intrahepatic cholangiocarcinoma.

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ARRS/AJR

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