Use of second generation contrast-enhanced ultrasound in the assessment of focal liver lesions

Figure 7 Potential pitfall: simple cysts. Gray-scale US image (A) and contrast-enhanced US scan images using a low MI technique (B and C). The gray-scale image (A) shows a typical simple hepatic cyst which is completely anechoic, has a thin wall and posterior acoustic enhancement (between arrowheads, A). After microbubble injection, no enhancement of the cyst is seen throughout all phases of enhancement (B and C). The diagnosis is straightforward if the lesion was recognised prior to contrast injection. If not, it may be misinterpreted as an enhancement defect and be categorized as a malignant lesion.