Differentiating malignant and benign focal liver lesions in children using CEUS LI-RADS combined with serum alpha-fetoprotein

Figure 2 LR-5 nodule in a 10-year-old boy. A: A hypoechoic nodule (arrow) measuring 7.3 cm in the right lobe of the liver was shown at conventional gray-scale US; B: The lesion was inhomogeneously hyperenhanced (arrow) in the arterial phase (14 s) at contrast-enhanced US; C: The lesion was seen iso-enhanced in the portal phase (60 s); D: Mild washout in the late phase (231 s) was shown. There were small areas of nonenhancement within the lesion during the whole process. The patient had a chronic hepatitis B viral infection. The serum AFP level was greater than 1210 ng/mL. This lesion was assigned to LR-5 and was confirmed as hepatocellular carcinoma by histopathologic analysis.