为了比较增强超声（CEUS）与含有六氟化硫（SHF）和全氟丁烷（PFB）微泡的超声对结直肠肝转移（CRLM）的检测效果。在2021年9月至11月进行的前瞻性研究中，连续招募结直肠癌患者，并进行同日超声、SHF-CEUS和PFB-CEUS检查。参考标准为增强磁共振成像和随访影像。记录了每个肝脏病灶的大小、深度、回声和钙化情况。根据两位盲审读者在外部评估的晚期（> 120秒）/库氏期（KP）清除出现情况来评估CRLM的数量和显著性。总共评估了78位患者的230个病灶（CRLM，n=219；良性病灶，n=11）。 SHF-CEUS和PFB-CEUS在病灶显著性（p=0.344）和CRLM检测准确性方面具有可比性（SHF的准确度为0.877，PFB的准确度为0.770，p=0.087）。 SHF-CEUS在LP清除阶段中（> 120秒）评估的直径≥10 mm的CRLM数量多于KP PFB-CEUS（p<0.001）。 PFB-CEUS在KP清除中评估的直径<10 mm的CRLM数量多于LP SHF-CEUS（p<0.001）。 PFB-CEUS的显著性优于SHF-CEUS（p=0.027）。在超声回声强，深于80 mm的病灶和钙化病灶中，PFB-CEUS上的CRLM显著性低于SHF-CEUS（p<0.05）。 SHF和PFB-CEUS在CRLM的检测准确性和显著性方面基本相当。PFB-CEUS在检测小型CRLM方面具有优势。然而，较大、高回声、深部或钙化病灶通过SHF-CEUS更易于检测。 SHF和PFB-CEUS在检测和显著性方面的CRLM的准确性方面基本相当。PFB-CEUS在检测小型CRLM方面具有优势，而SHF-CEUS在检测较大、高回声、深部或钙化病灶方面表现更好。 结合六氟化硫的超声晚期和全氟丁烷微泡的库氏期相比，检测和显著性方面对于结直肠肝转移具有相当的精确性。在使用全氟丁烷微泡时，小的结直肠肝转移（<10 mm）更容易通过库氏期超声成像来识别。在使用六氟化硫微泡时，较大、高回声、深部或钙化病灶更容易通过晚期超声成像（>120 s）来识别。 ©2023.作者，专属于欧洲放射学学会。

To compare contrast-enhanced ultrasound (CEUS) with microbubbles containing sulfur hexafluoride (SHF) and perfluorobutane (PFB) for the detection of colorectal liver metastasis (CRLM).In this prospective study, conducted from September to November 2021, patients with colorectal cancer were consecutively recruited and underwent same-day ultrasound, SHF-CEUS, and PFB-CEUS. The reference standard was contrast-enhanced MRI and follow-up imaging. The size, depth, echogenicity, and calcification of each focal liver lesion were recorded. The number and conspicuity of CRLMs, based on washout appearance during the late phase (LP) (> 120 s)/Kupffer phase (KP), were evaluated offsite by two blinded readers.Overall, 230 lesions (CRLMs, n = 219; benign lesions, n = 11) in 78 patients were evaluated. Lesion conspicuity (p = 0.344) and accuracy in the detection of CRLM were comparable for SHF- and PFB-CEUS (0.877 for SHF vs. 0.770 for PFB, p = 0.087). More CRLMs ≥ 10 mm were identified by LP contrast washout in SHF-CEUS than in KP PFB-CEUS (p < 0.001). More CRLMs < 10 mm were identified by KP washout in PFB-CEUS than in LP SHF-CEUS (p < 0.001). Conspicuity was better on PFB-CEUS than on SHF-CEUS (p = 0.027). In hyperechoic lesions, lesions located deeper than 80 mm, and calcified lesions, CRLM conspicuity on PFB-CEUS was inferior to that on SHF-CEUS (p < 0.05).The overall accuracy of detection and conspicuity of washout in CRLMs were comparable between SHF and PFB-CEUS. PFB-CEUS has the advantage of identifying washout in small CRLMs. However, larger, hyperechogenic, deep-seated, or calcified lesions were better identified using SHF-CEUS.Accuracy of detection and conspicuity of washout in CRLMs were comparable between SHF- and PFB-CEUS. PFB-CEUS has the advantage in detecting small CRLMs, whereas SHF-CEUS is better for detecting larger, hyperechogenic, deep-seated, or calcified lesions.Contrast-enhanced ultrasound with sulfur hexafluoride in the late phase and perfluorobutane microbubbles in the Kupffer phase were comparable in terms of accuracy in the detection and conspicuity of colorectal liver metastases. Small colorectal liver metastases (< 10 mm) were more often identified in the Kupffer phase contrast-enhanced ultrasound imaging when using perfluorobutane microbubbles. Larger, hyperechogenic, deep-seated, or calcified lesions were better identified in the late phase contrast-enhanced ultrasound imaging (> 120 s) when using sulfur hexafluoride microbubbles.© 2023. The Author(s), under exclusive licence to European Society of Radiology.