Patterns of liver metastases at CEUS. Lesions are indicted by white arrows. Upper row. In conventional B-mode ultrasound (left frame) the focal liver lesions is hardly visibile, showing a faint hyperechoic apperance. During the arterial phase (23 seconds after contrast injection, central frame) the lesion shows a rim- like hyperechoic aspect, whereas it becomes practically anechoic during the late phase (160 seconds after injections, right frame), consistently with a metastasis from left colonic adenocarcinoma. Lower row: in conventional B-mode ultrasound (left frame) this metastasis from rectal adenocarcinoma appears inhomogeneous, predominantly hypoechoic, whereas it becomes homogeneously hyperechoic during the arterial phase (32 seconds after contrast injection, central frame) and washes contrast out in the late phase, becoming markedly hypoechoic (125 seconds after injection, right frame).