Delayed contrast enhancement of hepatic parenchyma after intravenous sonographic contrast agent: unusual phenomenon. Case report and review of literature.

AIM: A case of heterogeneous late-phase hepatic enhancement (HLHE) using contrast-enhanced ultrasound (CEUS) with SonoVue is presented, where HLHE lasted after 50 min of injection. METHODS: This study aims to review prior literature on this topic, to characterize the features of HLHE in the liver, and to find possible and reliable explanations for this phenomenon. RESULTS: From literature, thus far five publications discuss this phenomenon with a total of 21 patients. CONCLUSION: We suggest that phagocytosis of contrast agent microbubbles by macrophages, and lymphocytosis of peripheral blood due to stress conditions of the patients might be in the background of HLHE.