Fig. 4

A liver mass discovered during physical examination in a 30-year-old male RF– patient. The mass was estimated to measure approximately 4.6 × 3.6 cm. A hypoechoic mass located in the caudate lobe with peripheral hyperechoic rim (fat) (A). On CEUS, the mass displayed hyperenhancement after contrast agent injection (B). Contrast agent washout was observed as a hypoenhancement at the lesion during the portal venous phase (156 s) (C) and hypoenhancing during the late phase (13 min 37 s) (D). The ‘Arterial phase hyperenhancement with whole showing marked washout in late in onset (60 s)’ lesion was classified as LR-5 based on the CEUS LI-RADS guidelines. Histopathology revealed the lesion to be an angiomyolipoma. CEUS = contrast-enhanced ultrasound; LI-RADS = Liver Imaging Reporting and Data System; LR = LI-RADS category; RF− = not high-risk for hepatocellular carcinoma per LI-RADS criteria