Liver mass Ultrasound: Difference between revisions

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==References==
==References==
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{{reflist|2}}
[[Category:Up-To-Date]]
[[Category:Oncology]]
[[Category:Medicine]]
[[Category:Hepatology]]
[[Category:Gastroenterology]]
[[Category:Surgery]]

Revision as of 02:18, 27 November 2017

Liver Mass Microchapters

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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
  • Well-demarcated
  • Homogeneous
  • Hyperechoic mass
  • May be hypoechoic in patients with fatty infiltration
Focal nodular hyperplasia
  • Detectable lesions
  • Central scar with displacement of peripheral vasculature (Doppler examination)
Hepatic adenoma
  • Large
  • Right lobe of the liver
  • Central hypoechoic region
Idiopathic noncirrhotic portal hypertension
  • Isoechoic lesions
Hepatocellular carcinoma
  • Poorly-defined margins
  • Coarse, irregular internal echoes
Cholangiocarcinoma
  • Hypo-, iso-, or hyperechoic
  • Homogenous or heterogenous
Metastases
  • Metastases from adenocarcinoma
  • Multiple and hypoechoic in comparison with the surrounding liver parenchyma



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References

  1. 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. 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.