Liver mass Ultrasound: Difference between revisions
No edit summary |
|||
Line 37: | Line 37: | ||
:*'''Central scar''': large central artery is usually present with spoke-wheel like centrifugal flow | :*'''Central scar''': large central artery is usually present with spoke-wheel like centrifugal flow | ||
:*'''Sonographic halo sign''': hypoechoic halo sign in liver metastases: used in hepatobiliary imaging, is a concerning feature for malignant lesion if the lesion is a hyperechoic liver lesion | :*'''Sonographic halo sign''': hypoechoic halo sign in liver metastases: used in hepatobiliary imaging, is a concerning feature for malignant lesion if the lesion is a hyperechoic liver lesion | ||
*The table below summarizes the characteristic ultrasound findings of common benign and malignant liver masses. | |||
{|style="border: 5px; font-size: 90%; margin: 5px; width: 1000px" align=center | |||
!style="padding: 5px 5px; background: #4479BA; font-weight: bold; text-align:center;" colspan="2"|{{fontcolor|#FFF|'''Ultrasound findings of common liver masses'''}} | |||
|valign=top| | |||
|+ | |||
!style="background: #4479BA; width: 300px; text-align:center;" | {{fontcolor|#FFF|'''Common liver masses'''}} | |||
!style="background: #4479BA; width: 300px; text-align:center;" | {{fontcolor|#FFF|'''Ultrasound finding'''}} | |||
|- | |||
|style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" | Hepatic hemangioma | |||
|style="padding: 5px 5px; background: #F5F5F5;"| | |||
*Well-demarcated | |||
*Homogeneous | |||
*Hyperechoic mass | |||
*May be hypoechoic in patients with fatty infiltration | |||
|- | |||
|style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" | Focal nodular hyperplasia | |||
|style="padding: 5px 5px; background: #F5F5F5;"| | |||
*Detectable lesions | |||
*Central scar with displacement of peripheral vasculature (Doppler examination) | |||
|- | |||
|style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" | Hepatic adenoma | |||
|style="padding: 5px 5px; background: #F5F5F5;"| | |||
*Large | |||
*Right lobe of the liver | |||
*Central hypoechoic region | |||
|- | |||
|style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" | Idiopathic noncirrhotic portal hypertension | |||
|style="padding: 5px 5px; background: #F5F5F5;"| | |||
*Isoechoic lesions | |||
|- | |||
|style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" | Hepatocellular carcinoma | |||
|style="padding: 5px 5px; background: #F5F5F5;"| | |||
*Poorly-defined margins | |||
*Coarse, irregular internal echoes | |||
|- | |||
|style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" | Cholangiocarcinoma | |||
|style="padding: 5px 5px; background: #F5F5F5;"| | |||
*Hypo-, iso-, or hyperechoic | |||
*Homogenous or heterogenous | |||
|- | |||
|style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" | Metastases | |||
|style="padding: 5px 5px; background: #F5F5F5;"| | |||
*Metastases from adenocarcinoma | |||
:*Multiple and hypoechoic in comparison with the surrounding liver parenchyma | |||
|} | |||
==Gallery== | ==Gallery== |
Revision as of 18:38, 28 March 2016
Liver Mass Microchapters |
Diagnosis |
---|
Treatment |
Case Studies |
Liver mass Ultrasound On the Web |
American Roentgen Ray Society Images of Liver mass Ultrasound |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]
Overview
Ultrasound is the initial method of choice for the evaluation of liver mass. On ultrasound, characteristic findings of liver mass, may include: fluid-filled spaces without clear walls, posterior acoustic enhancement, anechoic, hypohechoic, or hyperechoic lesions. The evaluation of liver mass will mainly depend on the echogenecity. Further evaluation with ultrasound should include Doppler examination to determine vascular pattern.[1][2]
Ultrasound
- Ultrasound is the initial method of choice for the evaluation of liver mass
- On ultrasound, characteristic findings of liver mass, may include:
- Fuid-filled spaces without clear walls
- Posterior acoustic enhancement
- Anechoic, hypohechoic, or hyperechoic lesions
- Ultrasound is the most useful diagnostic test for simple cysts
- Further evaluation with ultrasound should include the following techniques:[2]
- Doppler examination
- Contrast-enhanced ultrasound
- The evaluation of liver mass will mainly depend on echogenecity
- On ultrasound, characteristic findings of benign liver mass, include:[2]
- Homogeneous hyperechogenicity
- Hypoechogenicity with hyperechoic rind
- Posterior sonic enhancement
- On enhanced ultrasound, characteristic findings of benign liver mass, include:
- Wash out during portal venous phase regardless of arterial vascularity
- On ultrasound, characteristic findings of malignant liver mass, include:[2]
- Hypoechoic halo
- Target appearance
- Hypoechoic
- On enhanced ultrasound, characteristic findings of malignant liver mass, include:[2]
- No wash-out during portal phase
- On ultrasound, radiological signs of liver mass, include:[2]
- Central scar: large central artery is usually present with spoke-wheel like centrifugal flow
- Sonographic halo sign: hypoechoic halo sign in liver metastases: used in hepatobiliary imaging, is a concerning feature for malignant lesion if the lesion is a hyperechoic liver lesion
- The table below summarizes the characteristic ultrasound findings of common benign and malignant liver masses.
Ultrasound findings of common liver masses | ||
---|---|---|
Common liver masses | Ultrasound finding | |
Hepatic hemangioma |
| |
Focal nodular hyperplasia |
| |
Hepatic adenoma |
| |
Idiopathic noncirrhotic portal hypertension |
| |
Hepatocellular carcinoma |
| |
Cholangiocarcinoma |
| |
Metastases |
|
Gallery
-
Central scar: This image shows the presence of focal nodular hyperplasia. Detectable lesions characteristically will demonstrate a central scar with displacement of peripheral vasculature on color Doppler examination
-
Sonographic halo sign: hypoechoic halo sign in liver metastases: used in hepatobiliary imaging, is a concerning feature for malignant lesion if the lesion is a hyperechoic liver lesion
References
- ↑ Bonder A, Afdhal N (2012). "Evaluation of liver lesions". Clin Liver Dis. 16 (2): 271–83. doi:10.1016/j.cld.2012.03.001. PMID 22541698.
- ↑ 2.0 2.1 2.2 2.3 2.4 2.5 Wilson SR, Jang HJ, Kim TK, Burns PN (2007). "Diagnosis of focal liver masses on ultrasonography: comparison of unenhanced and contrast-enhanced scans". J Ultrasound Med. 26 (6): 775–87, quiz 788–90. PMID 17526609.