Abstract: Objective The aim of this study was to summarize the contrast-enhanced ultrasound (CEUS) features of hepatic hemangioma (HCH), hepatocellular carcinoma (HCC)and hepatic angiomyolipoma(HAML). Methods A total of 112 patients with intrahepatic occupying lesions were encountered in our hospital between November 2017 and November 2020, and all underwent histopathological examination. The patients received conventional sonography and CEUS check-up after admission before treatment. Two experienced ultrasound physicians read the images in a blind way to observe the number, size, boundary, echo, morphology, blood supply and other information of hepatic lesions in conventional ultrasound examination, and observe the enhancement pattern at arterial phase, portal vein phase and delayed phase in contrast-enhanced ultrasound examination. Results The histopathological examination showed HCH in 39 cases, HCC in 64 cases and HMAL in 9 cases out of our series; the female accounted for 66.7% in patients with HCH, significantly higher than 18.8% in patients with HCC or 33.3% in patients with HAML (P＜0.05), the average age of patients with HCC was (57.5±5.8)yr, and that in patients with HMAL was (55.3±5.1)yr, both significantly higher than [(46.2±5.2)岁, P<0.05] in patients with HCH, the incidence of hepatitis B viral infection in patients with HCC was 76.6%, significantly higher than 28.6% in patients with HMAL or 12.8%(P<0.05)in patients with HCH; the conventional ultrasound scan showed that the proportions of unclear boundary, low echo and mixed echo of lesions in patients with HCC were 65.6%, 43.8% and 42.2%, significantly higher than 2.6%, 10.3% and 7.7% in patients with HCH or 0.0%, 11.1% and 11.1% in patients with HAML(P＜0.05), and there were no significant differences as respect to hepatic tumor number, size, shape and blood supply among lesions in patients with HCH, HCC and HAML(P＞0.05); the CEUS demonstrated the percentage of intensified enhancement of HCH lesions at arterial phase was 92.3%, significantly higher than 87.5% in HCC lesions or 88.9% in HMALlesions (P＜0.05), the proportion of low enhancement of lesions at portal phase and delayed phase in patients with HCC were 65.6% and 90.6%, both significantly higher than 5.1% and 43.6% in patients with HCH or 11.1% and 22.2% in patients with HMAL(P＜0.05). Conclusion The conventional ultrasound and contrast-enhanced ultrasonography are helpful in diagnosing and discriminating intrahepatic occupying lesions, which warrants further clinical multi-central study.

Key words: Hepatoma, Hepatic hemangioma, Hepatic angiomyolipoma, Contrast-enhanced ultrasound, Diagnosis