Patient enrollment process.

PurposeTo assess the efficacy of contrast vector imaging (CVI) in detecting tumoral vascular structures and flow characteristics of focal liver lesions (FLLs) for differential diagnosis.Materials and methodsIn this prospective study, 65 participants with FLLs underwent CEUS using SonoVue with high-frame-rate imaging technique between July 2019 and October 2020. CVI was obtained by post-processing arterial cine imaging of CEUS. Tumoral vascular structures, velocity histogram, and mean velocities were compared among hepatocellular carcinoma (HCC), non-HCC malignancies, and benign tumors using the Chi-square and Kruskal-Wallis tests, respectively. The areas under the receiver operating characteristic curve (AUC) of CEUS in determining HCC probability was compared to that of CEUS with CVI using a z-test.ResultsCVI was technically successful in 52 of 65 (80%) participants (19 HCCs, 13 non-HCC malignancies, and 20 benign tumors). The detectability of tumoral vascular structures was significantly higher in CEUS with CVI, compared to CEUS alone (46.2% [24/52] vs. 100.0% [52/52], pConclusionCEUS with CVI better visualized vascular structures and flow characteristics of FLLs, and showed better diagnostic performance in determining HCC probability than CEUS.