Advanced Ultrasound in Diagnosis and Therapy ›› 2023, Vol. 7 ›› Issue (4): 321-332.doi: 10.37015/AUDT.2023.230041

• Review Articles • Previous Articles     Next Articles

Contrast-Enhanced Ultrasound LI-RADS: A Pictorial Review

Osama Mahmoud, BSa, Ajay Makkena, BSa, Corinne E. Wessner, MS, MBA, RDMSb, Ji-Bin Liu, MDb, John R. Eisenbrey, PhDb, Andrej Lyshchik, MD, PhDb,*()   

  1. aSidney Kimmel Medical School, Thomas Jefferson University, Philadelphia, USA
    bDepartment of Radiology, Thomas Jefferson University and Hospital, Philadelphia, USA
  • Received:2023-06-21 Revised:2023-07-21 Accepted:2023-08-20 Online:2023-12-30 Published:2023-10-23
  • Contact: Department of Radiology, Thomas Jefferson University, 7th Floor Main Building, 132 S. 10th Street, Philadelphia, PA 19107, USA. e-mail:,


The American College of Radiology has implemented the Liver Imaging Reporting and Data System (LI-RADS) to help detect, interpret, and guide the management of suspected lesions on surveillance imaging for hepatocellular carcinoma (HCC) in patients with cirrhosis. The classification of indeterminate nodules with a grading algorithm can be used for multiple imaging modalities (US, CT, and MRI) and incorporates multiple imaging features to appropriately classify observations with different likelihood of being HCC. Contrast-enhanced ultrasound (CEUS) LI-RADS has been fully implemented since 2017. The aim of this pictorial article is to provide a comprehensive review of CEUS LI-RADS utilization, discuss its advantages, and highlight areas for potential improvement.

Key words: Hepatocellular carcinoma; Liver imaging reporting and data system; LI-RADS; Contrast-enhanced ultrasound