Abstract: Objective The aim of this study was to investigate the diagnostic efficacy of liver contrast-enhanced ultrasound (CEUS), shear wave elastography (SWE) and contrast-enhanced CT scan in patients with occupying lesions in liver (OLL). Methods 128 patients with OLL were encountered in our hospital between June 2020 and June 2022, and all underwent CEUS, SWE and CT scan at presentation. The histopathological and/or cytology examination were performed after operation. Results Out of the 128 patients with OLL, the pathological examination showed hepatocellular carcinoma (HCC) in 72 cases and benign lesions in 56 cases; there were obvious differences as respect to the enhancement patterns in arterial, portal and delayed phases between malignant and benign lesions (P＜0.05). 79.2% HCC presented with “fast in and fast out”, with 81.9% of increased enhancement at arterial phase, 62.5% of low enhancement at portal phase and 79.2% of low enhancement at delayed phase, while 80.4% benign lesions showed "slow in and slow out", with 44.6%, 76.8% and 80.4% of equal enhancement at arterial, portal and delayed phases. The diagnostic sensitivity (Se), specificity (Sp) and accuracy (Ac) by CEUS detection were 83.3%, 87.5% and 85.2%; the Young's modulus (Emax) in malignant lesions was (42.5±7.1)kPa, much higher than [(36.3±6.5)kPa, t=5.064, P＜0.01] in benign lesions. When the Emax≥39.6 kPa was set as the cut-off-value, the Se, Sp and Ac by SWE were 79.2%, 76.8% and 78.9%; 77.8%HCC presented as “fast in and fast out” at contrast-enhanced CT scan, with 83.3% of intensified enhancement at arterial phase, 59.7% of low enhancement at portal phase and 77.8% of low enhancement at delayed phase, while 82.1% of benign lesions presented with "slow in and slow out", with 42.9%, 78.6% and 82.1% of equal enhancement at arterial, portal and delayed phases. The Se, Sp and Ac by CT scan were 77.8%, 87.5% and 82.0%. Conclusion The CEUS and CT scan are both important measures for the diagnosis of patients with HCC, and the SWE might be an alternative approach for auxiliary diagnosis.

Key words: Hepatoma, Occupying lesions in liver, Contrast-enhanced ultrasonography, Shear wave elastography, Contrast-enhanced CT, Diagnosis