Introduction Contrast-enhanced ultrasound (CEUS) is now gaining popularity as a key a tool for demonstration and detection of focal liver lesions. It has replaced the normal medical ultrasound as an imaging technique. A normal medical ultrasound as an imaging technique has generally been the gold standard diagnostic imaging technique for the liver across the world. Its pros lie in its affordability and availability. However, one of its major pitfalls is its reliability in demonstrating focal lesions despite the advent of Doppler. This has often been a major challenge because of the grey scale appearances of the sonograms causing blurring patterns. Small lesions with diameters >1cm and iso-echoic lesions too pose great difficulty in this diagnostic modality. The sensitivity is poor with a false-negative rate of > 50 % (Wernecke et al 1991, p. 731). In addition, inaccessibility to the eighth of the liver is a major setback in detecting lesions in the segment. With the advent of Doppler ultrasound, more insight in the diagnosis of liver lesions has been added by the use of the arterial patterns whose abnormality may be characteristic of certain pathology e.g. the spoke wheel pattern observed in focal nodular hyperplasia. Contrast enhanced ultrasound involves intravenous injection of contrast media (microbubbles) prior to the ultrasound procedure. The microbubbles remain in the systemic circulation for a given duration of time during which ultrasonic waves are directed to the anatomic site of organ pathology. An echo is then reflected by the microbubbles which are then converted into contrast-enhanced image by the ultrasound system. The operator needs to familiarize himself with the ultrasound equipment and its ‘contrast’ settings, which is dependant on the type of machine. The contrast agent is prepared according to instructions provided. 20 ml of normal saline should be given following the administration of the contrast. An intravenous cannula is placed away from the side of ultrasound examination. A stop-watch in the machine is used for accurate interpretation of the phase of imaging (Arterial, venous and late phases). Scanning is then done for a period of at least 5 minutes. The examination may be video recorded for later review. Still images are also taken at points to help highlight the pathology. Some focal lesions in the liver not demonstrable on ultrasound may not be suitable for demonstration with contrast agents. Small lesions <1 cm, may be difficult to characterize especially when deep within parenchyma, generally.However, liver metastases, even those < 0.5 cm, are normally demonstrated using slow infusions through the liver in the later portal-venous phase or the late phase. The characterization of focal liver lesions forms a key element in the majority of radiological practices. Although the normal medical ultrasound imaging is useful for the identification of focal liver lesions, accurate demonstration and characterization of a lesion is often difficult even with the use of colour Doppler (Nino-Murcia et al., 1992, p. 1195). Microbubble contrast enhanced ultrasound (CEUS) has proven diagnostic accuracy in focal liver lesions (Bleuzen et al.,