Contrast-enhanced ultrasound is useful for the evaluation of focal liver lesions in children

• Introduction: Contrast-enhanced ultrasound (CEUS) is a widely used diagnostic method. In adults, it has been proven to be a useful alternative to CT and MRI for the characterisation of focal liver lesions (FLLs). However, since there is no official paediatric licensing for any ultrasound contrast agents in Europe, its use has been restricted. Purpose: To retrospectively outline our experience with CEUS as a tool for the characterisation of FLLs in paediatric patients. Methods: An eleven-year retrospective single-centre study. During this period, we identified 287 CEUS examinations performed on children, of these 36 were relevant first-time examinations with the aim of characterising a focal liver lesion. Clinical and radiological data were collected from the hospital chart. Results: The overall agreement between the CEUS diagnosis and the reference diagnosis for benign versus malignant differentiation was 75%. When analysing conclusive CEUS examinations only, the overall agreement was 96%. The specificity for correctly characterising a lesion as benign was 96%, and the negative predictive value was 100%. No side effects from CEUS were detected. Conclusions: Our study reinforces that CEUS can be useful in the medical workup for the identification and classification of focal liver lesions in children.

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