Sono‐Vasomics With Super‐Resolution Contrast‐Enhanced Ultrasound (SR‐CEUS) for Characterization of Focal Liver Lesions: A Case Report

ABSTRACT Accurate differentiation between benign and malignant focal liver lesions (FLLs) remains a major diagnostic challenge. Vasomics, an emerging discipline, classifies vascular phenotypes into anatomical, biomechanical, biochemical, pathophysiological, and composite categories. Sono‐Vasomics, the ultrasound‐based subset, leverages super‐resolution contrast‐enhanced ultrasound (SR‐CEUS) for real‐time microvascular phenotyping. A 32‐year‐old male patient presented to our hospital with multiple large hepatic masses for ultrasound examination. On B‐mode ultrasound, the lesion appeared as multiple large, well‐defined hypoechoic masses with heterogeneous echogenicity. SR‐CEUS revealed thick, straight, non‐tortuous vessels with regular branching and homogeneous perfusion. Quantitative Sono‐Vasomics based on SR‐CEUS demonstrated vessel density 21.74%, flow‐weighted density 10.55, fractal dimension 1.51, velocity variance 172.98, direction variance 2672.52, and perfusion index 4.48. Mapping these values to vasomics categories identified benign anatomical and biomechanical vascular phenotypes, excluding malignancy and suggesting hepatic adenoma. Based on the gene sequencing results confirming glycogen storage disease type Ia (GSD Ia), together with the clinical and laboratory findings of fasting hypoglycemia, hyperuricemia, hyperlactatemia, and hypertriglyceridemia, as well as a history of hepatomegaly, the patient was ultimately diagnosed with hepatic adenoma. In this case, quantitative vascular phenotyping helped accurately characterize hepatic adenoma and may reduce misdiagnosis. By aligning imaging‐derived vascular phenotypes with the vasomics framework, Sono‐Vasomics provides a clinically feasible implementation of vasomics and suggests the potential value of integrating imaging and genomics in hepatology.