Fig. 2. Metastasis of rectal adenocarcinoma in a 55-year-old man showing ill-defined B-mode isoechoic nodules, distributed in the liver parenchyma.

A. Pre-contrast-enhanced ultrasonography is shown. B-E. After the injection of contrast agent, 0.14 minutes, 0.21 minutes, 0.48 minutes and 4.28 minutes post contrast injection), several nodules (and additional nodules) are observed with arterial hyperenhancement and rapid washout (portal and late phase). B, C. Early arterial phase (14 seconds and 21 seconds) shows hyperenhancement that starts in nodule periphery and progresses to total highlighting of the nodule (C); early washout at 48 seconds, in the portal venous phase, defines better the multiple nodules in the liver parenchima (D); late phase shows intense washout, with best nodules definition (E).