Diagnostic Ultrasound - Abdomen and Pelvis
Hepatic Cyst (Left) Transverse and longitudinal grayscale views of the liver show a cyst st with barely perceptible septation . (Right) High-resolution transverse grayscale US of the liver shows a small cyst st under the liver capsule with a well-defined back wall . Diagnoses: Liver (Left) Transverse grayscale US of the liver shows innumerable cysts st throughout the liver in a patient with polycystic liver disease. (Right) Transverse color Doppler US of the liver confirms that multiple cysts st in the liver do not have internal vascularity. (Left) Longitudinal oblique US of the liver shows a complicated liver cyst with internal layering debris from hemorrhage. (Right) Axial T2 FS MR in the same patient shows layering low signal in the complicated cyst reflecting internal blood components. http://radiologyebook.com/ 199
Biliary Hamartoma Diagnoses: Liver TERMINOLOGY • Benign malformations of biliary tract • Synonyms: von Meyenburg complex, bile duct hamartoma IMAGING • Ultrasound ○ Grayscale ultrasound – Numerous small, hypoechoic or hyperechoic foci uniformly distributed throughout liver □ Leads to inhomogeneous and coarse appearance of liver echotexture – Multiple echogenic foci, often with associated "comet tail" artifacts – Typically smaller lesions appear as echogenic foci whereas larger lesions appear cystic □ Often extent of echogenic foci on ultrasound is greater than anticipated, based on comparison CT or MR ○ Color Doppler ultrasound KEY FACTS – Twinkling artifact may be seen • MRCP ○ Numerous scattered, tiny cysts without communication between lesions and biliary tree TOP DIFFERENTIAL DIAGNOSES • Multiple simple hepatic cysts • Multiple small hepatic metastasis • Hepatic microabscesses • Autosomal dominant polycystic liver disease • Caroli disease CLINICAL ISSUES • May be misdiagnosed as multiple hepatic metastasis, microabscesses, cirrhosis, lymphoma, leukemia, etc. at initial imaging • No further evaluation necessary when seen as isolated finding in healthy, nononcologic patient (Left) Grayscale ultrasound of liver with numerous biliary hamartomas shows diffuse inhomogeneous and coarse parenchymal echotexture with numerous small, hypoechoic ſt and hyperechoic st foci. Note some echogenic foci have associated "comet tail" artifacts . (Right) Grayscale ultrasound of the liver shows diffuse, coarse, parenchymal echotexture with multiple echogenic foci, some with associated "comet tail" artifacts ſt generated from the biliary hamartomas. (Left) Grayscale ultrasound of the liver in a patient with multiple biliary hamartomas as evidenced by multiple tiny echogenic foci, some of which are associated with "comet tail" artifacts st. (Right) Grayscale ultrasound of liver shows heterogeneous echotexture of liver parenchyma due to numerous tiny, hypoechoic nodules ſt representing biliary hamartomas. Note several "comet tail" artifacts emanating from several of the hamartomas . 200 http://radiologyebook.com/
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- Page 212 and 213: Hepatic Schistosomiasis TERMINOLOGY
- Page 214 and 215: Venoocclusive Disease TERMINOLOGY A
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- Page 218 and 219: Hepatic Cyst TERMINOLOGY Synonyms
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- Page 226 and 227: Caroli Disease TERMINOLOGY Synonyms
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- Page 230 and 231: Biloma TERMINOLOGY Definitions •
- Page 232 and 233: Biliary Cystadenoma/Carcinoma TERMI
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- Page 236 and 237: Pyogenic Hepatic Abscess TERMINOLOG
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- Page 244 and 245: Hepatic Echinococcus Cyst TERMINOLO
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Hepatic Cyst<br />
(Left) Transverse <strong>and</strong><br />
longitudinal grayscale views of<br />
the liver show a cyst st with<br />
barely perceptible septation<br />
. (Right) High-resolution<br />
transverse grayscale US of the<br />
liver shows a small cyst st<br />
under the liver capsule with a<br />
well-defined back wall .<br />
Diagnoses: Liver<br />
(Left) Transverse grayscale US<br />
of the liver shows innumerable<br />
cysts st throughout the liver<br />
in a patient with polycystic<br />
liver disease. (Right)<br />
Transverse color Doppler US of<br />
the liver confirms that<br />
multiple cysts st in the liver<br />
do not have internal<br />
vascularity.<br />
(Left) Longitudinal oblique US<br />
of the liver shows a<br />
complicated liver cyst with<br />
internal layering debris <br />
from hemorrhage. (Right)<br />
Axial T2 FS MR in the same<br />
patient shows layering low<br />
signal in the complicated<br />
cyst reflecting internal blood<br />
components.<br />
http://radiologyebook.com/<br />
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