In patients with chronic liver disease undergoing surveillance for hepatocellular carcinoma, DWI MRI screening shows similar sensitivity to screening ultrasound but with a significantly lower false-positive rate.

A wide variety of pathologies can produce focal lesions within the spleen. These are being more frequently encountered as imaging technology improves. It is vital that radiologists are aware of these pathologies to enable accurate diagnosis. The role of ultrasound contrast in splenic disease will be discussed and illustrated with cases likely to be encountered by general and abdominal radiologists.

Focal lesions within the spleen are being increasingly recognized as imaging technologies advance, and often provide a diagnostic challenge for radiologists. Knowledge of the types of pathologies that occur, determination of solid or cystic nature and a search for characteristic features including correlation with extrasplenic findings can usually allow a specific diagnosis or brief differential to be offered.

Renal transplants are the most frequent visceral transplant, and because of the absence of nephrotoxicity and radiation, ultrasound is widely used to monitor grafts and assess for complications. Complications can be categorised as vascular, parenchymal, ureteric and perinephric collections, with many occurring at predictable times post transplant. Awareness of these pathologies and their features is vital for all radiologists to enable early intervention and prolong graft survival.

Ultrasound contrast agents have gained wide acceptance for the detection and characterization of focal liver lesions. This pictorial essay reviews the growing body of evidence that supports the use of modern ultrasound contrast agents and illustrates the enhancement characteristics of commonly encountered focal liver lesions. Pathologies discussed include metastases, hepatocellular carcinomas, focal nodular hyperplasia, hepatocellular adenomas, hemangiomas, abscesses, complex cysts, and focal fatty deposition.