Abstract: Objective The aim of this study was to evaluate the clinical application of contrast-enhanced ultrasonography (CEUS) in guiding liver biopsy in patients with space-occupying lesions (SOL). Methods The clinical data of 80 patients with SOL encounted in our Department of Ultrasound were retrospectively analyzed, and all underwent liver biopsy under US guidance. Before the liver biopsies, the CEUS was done in 50 cases, and the routine gray-scale US examination was performed in 30 cases. The diagnostic efficacy was compared between the two groups. Results The proportion of demonstrated necrotic areas in lesions in patients receiving CEUS was significantly increased (56.0% vs. 30.0%, P = 0.024), and the successful puncture rate in obtaining sampling was significantly higher (100.0% vs. 90.0%, P=0.022) as compared with those having gray-scale ultrasound scan; there was no significant difference in puncture times between the two groups (3.0±0.8 vs. 2.9±0.8, P=0.590); the sensitivity, specificity and accuracy by CEUS guidance were 97.8%, 100%, and 98.0%, significantly higher than in gray-scale ultrasound guidance (80.8%, 75.0% and 80.0%, respectively, all P< 0.05); no severe bleeding, pneumothorax, bile leakage and other complications occurred in all patients in the two groups. Conclusion The liver biopsies under CEUS guidance in patients with SOL could improve the puncture success and diagnostic efficacy, which warrants further clinical investigation.

Key words: Liver space-occupying lesions, Contrast-enhanced ultrasound, Liver biopsy, Diagnosis