In investigation of liver lesions, continuous observation of contrast behaviour is possible with, and is an important strength of, contrast ultrasound at a low mechanical index. In many institutions contrast enchanced ultrasound using SonoVue in focal liver lesions has become a routine investigation. At our department contrast ultrasound is predominantly used to further characterise lesions which appear uncharacteristic at grey-scale ultrasound. We were able to show that contrast ultrasound with SonoVue is superior or equal to CT in the majority of cases. Using contrast ultrasound after inconclusive grey-scale ultrasound testing often enables adequate lesion characterisation without the necessity of CT or MRI.