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Portable ultrasound devices are surprisingly effective in the hands of experienced examiners. Imaging quality is predictably inferior to so-called high-end devices. Nearly all acute and therapeutically relevant diagnoses and findings were registered, even though nearly a quarter of the findings diagnosed with the high-end device were overlooked. These findings were mostly clinically irrelevant or very small in size. As could be expected, problems arose with pathological findings requiring high resolution, i.e., liver metastases, tiny gallstones, appendicitis, Crohn's disease etc. These form a clear indication for a high-end ultrasound examination.

Typical echodense haemangiomas of the liver can easily be identified by B-scan ultrasound. Atypical or giant haemangiomas of the liver, however, need to be differentiated from secondary tumours or primary liver carcinomas and cholangiocarcinomas. Until recently, computed tomography or magnetic resonance tomography were required to confirm the diagnosis, and not so rarely even a fairly risky fine-needle puncture had to be performed. Contrast media-assisted sonography, in general, offers the same scope of differentiating liver tumours as the radiographic tomography methods. Contrast media-assisted sonography is not yet widely available and has not been sufficiently evaluated. One important limitation is thought to be the lack of echo depth. We demonstrate the diagnostic value of this method in the case of a liver haemangioma measuring more than 20 cm in diameter. The resulting clinical questions are being discussed.

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