Abstract: Objective The aim of this study was to investigate the qualitative diagnosis of hepatic space-occupying lesions (SOL) by contrast-enhanced ultrasonography (CEUS). Methods 97 patients with hepatic SOL were encountered in our hospital between January 2020 and January 2023, and all underwent fine needle aspiration biopsies, and conventional ultrasonography and CEUS. The CEUS data were analyzed by Tom Tec Sono Liver CAP software and the area under receiver operating characteristic curve (AUC) was applied to evaluate the diagnostic efficacy. Results The pathological examination showed that there were malignant lesions in 41 patients, including cholangiocarcinoma in 5 cases, metastatic liver cancer in 10 cases and hepatocellular carcinoma in 26 cases, and benign lesions in 56 patients, including focal nodular hyperplasia in 29 cases and inflammatory pseudotumors in 27 cases; the regional blood flow (rBF) at arterial phase in malignant foci was (63.9±12.1)mL/min, much greater than [(42.7±8.9)mL/min, P<0.05], while the rBF at delayed phase was (17.6±2.4)mL/min, much smaller than [(19.0±2.7)mL/min, P<0.05] in benign foci; the initial peak time, peak time, ascent time and passage time in malignant lesions were(11.5±2.1)s, (34.1±6.9)s, (25.8±4.3)s and (110.5±20.7)s, significantly shorter than [(14.1±2.3)s, (45.9±6.2)s, (37.6±5.8)s and (149.3±24.1)s, respectively, P<0.05], while the perfusion index was(141.2±20.0), much greater than [(89.7±18.9), P<0.05] in benign lesions; the sensitivity, specificity, accuracy, positive predictive value and negative predictive value by conventional ultrasonography in differentiating benign from malignant lesions were 82.9%, 78.4%, 78.4%, 70.8% and 85.7%, while they were 80.5%, 82.1%, 81.4%, 76.7% and 85.2% by CEUS. Conclusion The CEUS has a high diagnostic performance in qualitative diagnosis in patients with hepatic SOL, which might help clinicians make an appropriate measure to deal with it.

Key words: Space-occupying liver lesions, Hepatoma, Contrast-enhanced ultrasonography, Diagnosis