CEUS videos

 

Videos of CEUS pathology in official CEUS indications, and our interpretations of the exams


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Haemangiomas:

Typical haemangioma with a small non-enhancing center.
Non-enhancing haemangioma characterized as such by being completely avascular. Probably thrombosed.
Fast flow haemangioma Typical, but very fast, enhancement from periphery. Solved with CEUS after CT was too slow.
Haemangioma resembling skip lesion on baseline.
Giant haemangioma Accidental finding of large tumor in right liver lobe.
Small quick haemangioma Both high MI and replenishment used for characterization.

FNH's:

Typical FNH Large FNH with all FNH characteristics present.
Uncharacteristic FNH Diagnosed as highly probable FNH on the basis of no washout in healthy individual. Small haemangioma is also seen.
FNH, "fire ball" Slow motion workup at workstation.
FNH, high MI study Typical FNH characteristics.
FNH, not characteristic FNH lacking central scar and typical vascular pattern. No washout.
Two small FNH's The larger one shows typical "fireball" enhancement from center and out.

Adenomas:

Adenoma Adenoma in young woman. Biopsy verified.
Courtesy of Dr. Knut Brabrand, Rikshospitalet University Hospital, Oslo, Norway

Fatty lesions:

Skip lesion Enhancement like the surrounding liver parenchyma, slightly brighter in late phase.
Focal fatty lesion Segmental hyperechoic lesion. Circulation exactly like surrounding liver in all vascular phases.

Abscesses:

Typical abscess slightly hyperemic capsule, no inflammatory washout.
Fungal abscesses biopsy verified. No liquefication. Enhancement pattern similar to that of metastases.

Metastases:

Hypervascular metastasis with rapid washout.
"Isovascular" metastasis practically "isovascular" with liver in arterial phase, quick washout.
Hypovascular metastasis hypoechoic to liver in all phases. Note the thick rim zones. Also necrotic metastasis and haemangioma.
Thin rim zone in the periphery of a metastasis that is gradually more necrotic toward centre.
Metastasis, large necrosis Almost complete washout in the viable superficial tissue.
Hypovascular metastasis Turns isovascular prior to washout

HCC's:

HCC, basket sign with slow motion workup. Diagnostic for HCC. Surgical resection performed on CEUS findings. Washout is not reliably strong.

Others:

Extramedullary haematopoiesis Biopsy verified. CEUS can not separate these lesions from metastases.