The role of CEUS as problem-solving technique when abdominal CT or MRI are inconclusive

Purpose To evaluate the role of CEUS in the characterization of abdominal lesions compared to CT and MRI and whether it could be “problem-solving” when CT and/or MRI are inconclusive or contraindicated. Methods A retrospective study was conducted on 39 patients (22 males; mean age: 64 years) with one or more abdominal focal lesions (total: 41; mean diameter: 2.9 cm) who underwent CEUS, had already undergone CT/MRI without a definitive diagnosis or had not undergone them due to contraindications. The frequency, out of the total lesions included, in which CEUS was problem-solving, confirmatory or inconclusive was evaluated. Results CEUS proved to be problem-solving for 20/41 (48.8%) lesions, confirmatory for 17/41 (41.5%) lesions and inconclusive for 4/41 (9.7%) lesions. Including problem-solving and confirmatory diagnosis, CEUS correctly identified 24/27 (88.9%) liver lesions, 11/11 (100%) kidney lesions, a gallbladder and a pancreatic lesion, while it did not provide useful information for 4/41 (9.7%) lesions, specifically three liver lesions and a testicular one. Conclusions CEUS is a promising technique when CT and/or MRI are inconclusive or contraindicated and to increase the radiologist’s diagnostic confidence.