Background and aims. We compared contrast-enhanced power Doppler sonography (CEPD) and phase-inversion harmonic imaging (PIHI) in the assessment of liver lesion vascularity and characterization of focal liver lesions.

Materials and methods. We examined 101 focal liver lesions by CEPD and PIHI using Optison as echo-enhancing agent. Amount and architecture of lesion vascularity and the kinetics of contrast enhancement in the lesions were analyzed. A tumor diagnosis was assessed after each examination.

Results. Analysis of tumor vascularity was not possible in 30 liver lesions (30%) due to motion or blooming artifacts by CEPD. Vascularity was detected in 61% of liver lesions by CEPD and in 95% by PIHI. PIHI identified significantly more tumor vascularity pattern (93%) than CEPD (57%). Specific lesion diagnosis based on PIHI led to correct results in 92% compared to 59% by CEPD.

Conclusion. PIHI is highly efficient in detecting tumor vascularity and is superior to CEPD in characterizing focal liver lesions.