Figure 1

Comparison of CT (left column) and contrast enhanced US (CEUS) (right column) appearance of liver metastases in the venous-late phases of portal perfusion. In the upper row a concordance is shown in the detections of a subcapsular metatasis localized in liver segment 7. Metastasis appears hypodense at CT and hypoechoic at CEUS (continuous-line arrows). In the middle and lower rows, two cases of discordance between CT and CEUS are shown. In the middle row the tiny subcapsular metastasis (dashed-line arrow) was detected by US, but not by CT. The metastastic nature of the lesion was confirmed intraoperatively at the time of resection of the primary cancer plus metastasectomy. In the lower row, the metastatic lesion (dashed-line arrow), located anteriorly in segment 6, was identified by CT and missed by CEUS. The malignant nature of the lesion was confirmed at surgery.