Evaluation of hepatic infantile hemangiomas: the potential of contrast-enhanced ultrasound.

OBJECTIVES: To evaluate laboratory parameters and to compare diagnostic findings of contrast-enhanced ultrasound (CEUS) and magnetic resonance imaging (MRI) in a cohort of patients with hepatic infantile hemangiomas (IH). MATERIALS AND METHODS: A retrospective multicenter analysis was conducted to identify infants diagnosed with hepatic IH who underwent CEUS, MRI, or both between 2016 and 2024. Lesion size and count were compared in patients who underwent both imaging modalities (6 patients). Data from 24 patients were included in the analysis; in 18 of them, only a single diagnostic imaging examination was performed. RESULTS: Laboratory parameters were mostly unremarkable, only Pro-Brain Natriuretic Peptide (proBNP) was elevated in a subset of patients. Of 24 patients, 15 underwent only CEUS, 3 underwent only MRI, and 6 received both imaging modalities. CEUS findings were comparable to MRI regarding lesion size and number. Treatment decisions were predominantly based on CEUS findings. CONCLUSION: Although laboratory abnormalities were uncommon, targeted assessment of proBNP and thyroid function may be clinically relevant in infants with extensive hepatic involvement. Both imaging modalities detected hepatic IH. CEUS demonstrated diagnostic findings largely consistent with MRI in hepatic hemangioma evaluation, suggesting its potential as a complementary tool without compromising disease severity assessment. CEUS advantages include real-time imaging and avoidance of sedation or anesthesia in young patients. These findings support the potential role of CEUS as a viable, readily available, and resource-efficient alternative to MRI for the evaluation of hepatic IH, enabling optimization of diagnostic and treatment protocols.