New signs and old applications of echo-color-Doppler should always be compared to a gold standard

In our previous study, we described a new Doppler sign, called ‘color-spot’, particularly suitable for identifying small hepatic arterio-venous malformations (HAVMs) and verified its accuracy using multislice CT (MSCT) as gold standard. Moreover, we clearly distinguished the color-spots found in the peripheral subcapsular region of the liver from ‘hepatic hypervascularization’, a sign previously reported by Caselitz et al.. Both are suggestive of small HAVMs and provide a greater diagnostic sensitivity for HAVMs in HHT when compared to previously published extrahepatic parameters