PURPOSE: To evaluate the patterns of the vascularities of hepatic tumors on both color Doppler (CDUS) and power Doppler ultrasonography (PDUS) before and after intravenous contrast (Levovist(R)) injection, and to assess the efficacy of this agent. MATERIALS AND METHODS: Thirty-two patients with focal hepatic tumors (21 hepatocellular carcinomas[HCC], 4 hemangiomas, 3 cholangiocarcinomas[CC], and 4 metastatic cancers) were evaluated with CDUS and PDUS. We rated the tumor vascularity before and after contrast enhancement as 'none', 'peripheral', 'penetrating', 'central', and the degree of enhancement as 'none', 'mild', 'marked'. We evaluated the characteristics of tumor vascularity and contrast enhancement of several types of tumors. RESULTS: CDUS and PDUS showed contrast enhancement in 71.9% and 90.6% of all 32 patients, and 61.9% and 90.5% of 21 patients with HCC, respectively. In HCC, 'peripheral pattern was mainly noted both before and after enhancement on CDUS, but peripheral before and 'penetrating' after enhancement were typically noted on PDUS (p<0.01). In hemangiomas, 'peripheral' pattern was mainly seen in both CDUS and PDUS. CC and metastatic cancers revealed variable patterns of vascularity and degree of enhancement. CONCLUSION: Ultrasound contrast agent showed contrast enhancement of tumorous vessels in 71.9% and 90.6%, respectively. In HCC, 'peripheral' before and penetrating after enhancement were typically noted on PDUS. In hemangiornas, 'peripheral' pattern was mainly seen in both CDUS and PDUS. CC and metastatic cancers had no typical patterns of tumor vascularity or enhancement degree.