CEUS LI-RADS for diagnosis of hepatocellular carcinoma in individuals without LI-RADS-defined hepatocellular carcinoma risk factors

Table 2 Imaging characteristics of different typos of liver nodules in rf- patients in retrospective study

Image Features	Malignant Lesions (n = 245)		Benign Lesions (n = 173)								Total
Image Features	HCC (n = 204)	OM (n = 41)	DN/RN (n = 22)	FNH (n = 28)	Hemangiom (n = 60)	Biliary adenoma (n = 4)	AML (n = 8)	IPT (n = 32)	Lipoma (n = 7)	NEN (n = 12)	Total
Gray-scale echogenicity
Hyperechoic	20	3	1	2	57	0	5	2	7	9	106
Hypoechoic	184	38	21	26	3	4	3	30	0	3	312
Arterial phase
Hyperenhancemenr
Homogeneous	184	6	18	28	31	2	7	29	3	11	319
Inhomogenous	2	2	0	0	14	0	0	0	0	1	19
Rim	5	20	0	0	2	0	1	1	0	0	29
Peripheral nodular	7	13	0	0	13	0	0	0	0	0	33
Isoenhancement	3	0	4	0	0	2	0	2	4	0	15
Hypoenhancement	3	0	0	0	0	0	0	0	0	0	3
Late phase enhancements
Isoenhancement	28	0	13	19	35	4	3	18	3	5	128
Hypoenhancement	172	41	4	0	7	0	2	12	0	2	240
Hyperenhancement	4	0	5	9	18	0	3	2	4	5	50
Washout
No washout	32	0	18	28	53	4	6	20	7	10	178
delayed and moderate	158	2	4	0	7	0	2	12	0	2	187
< 60 s	9	22	0	0	0	0	0	1	0	0	32
Marked, ≤120 s	2	18	0	0	0	0	0	0	0	0	20

Note: Data are numbers of nodules. HCC hepatocellular carcinoma, OM Other malignant nodules (including lymphoma, inrrahepatic cholangiocarcinoma and HCC-ICC), DN dysplastic nodule, RN regenerative nodule, AML angiomyolipoma, IPT inflammatory pseudotumor, NEN neuroendocrine neoplasm
A full description can be found on the official website of the American College of Radiology (https://www.acr.org/Clinical-Resources/Reporting-and-Data-Systems/LI-RADS/CEUS-LI-RADS-v2017). Washout is defined as whole or partial hypoenhancement relative to liver beginning in or after the arterial phase. Early washout occurs within 60 seconds after injection of the contrast agent. Punched-out appearance is defined when the nodule becomes markedly hypoenhanced (appears black). Marked washout is assigned when punched-out appearance occurs within 2 minutes (otherwise defined as mild)

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