CEUS LI-RADS: a pictorial review

Area of Science:

• Radiology and Medical Imaging
• Hepatology
• Oncology

Background:

• Focal liver lesions (FLLs) in cirrhotic patients require accurate diagnosis to detect hepatocellular carcinoma (HCC).
• Contrast-enhanced ultrasound (CEUS) is a valuable tool recommended by international guidelines for evaluating FLLs in at-risk populations.
• Standardized reporting systems are crucial for consistent interpretation of imaging findings.

Purpose of the Study:

• To illustrate the characteristic features of liver nodules detected via CEUS in cirrhotic livers.
• To demonstrate the application of the CEUS Liver Imaging Reporting and Data System (LI-RADS) for classifying these nodules.
• To enhance diagnostic accuracy for hepatocellular carcinoma (HCC) in patients with cirrhosis.

Main Methods:

• A pictorial essay approach was used, presenting representative CEUS images of liver nodules.
• Nodules were categorized according to the established CEUS Liver Imaging Reporting and Data System (LI-RADS) criteria.
• Emphasis on visualizing and describing enhancement patterns and washout characteristics.

Main Results:

• CEUS demonstrated improved diagnostic performance in characterizing FLLs compared to conventional ultrasound.
• Specific CEUS LI-RADS categories were visually correlated with distinct imaging features of liver nodules.
• The study highlights key CEUS findings indicative of hepatocellular carcinoma (HCC) in cirrhotic livers.

Conclusions:

• CEUS, guided by LI-RADS, is an effective method for the diagnosis and characterization of FLLs in cirrhotic patients.
• Standardized reporting through CEUS LI-RADS facilitates accurate identification of hepatocellular carcinoma (HCC).
• This pictorial essay serves as a visual guide to CEUS features of liver nodules within the LI-RADS framework.