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Diagnostic Ultrasound - Abdomen and Pelvis

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Diffuse Liver Disease<br />

Acute/Chronic Hepatitis<br />

Hepatocellular Carcinoma<br />

(Diffuse/Infiltrative)<br />

(Left) Longitudinal abdominal<br />

ultrasound in a patient who<br />

presented with acute liver<br />

failure from acute alcoholic<br />

hepatitis shows marked<br />

hepatomegaly <strong>and</strong> slightly<br />

echogenic liver parenchyma<br />

ſt. (Right) Transverse<br />

abdominal ultrasound shows<br />

diffusely increased hepatic<br />

parenchymal echogenicity<br />

with multiple refractive<br />

shadows ſt caused by diffuse,<br />

infiltrative hepatocellular<br />

carcinoma (HCC). Hepatic<br />

surface nodularity st <strong>and</strong><br />

ascites indicate underlying<br />

cirrhosis.<br />

Differential Diagnoses: Liver<br />

Infiltrative Metastasis<br />

Biliary Hamartomas<br />

(Left) Abdominal color<br />

Doppler ultrasound in a<br />

patient with renal cell<br />

carcinoma shows diffusely<br />

heterogeneous liver<br />

echogenicity caused by diffuse<br />

hepatic metastases ſt. Main<br />

portal vein is filled with<br />

hypoechoic material <strong>and</strong><br />

shows no blood flow,<br />

suggesting thrombosis st.<br />

(Right) Oblique abdominal<br />

ultrasound shows diffuse <strong>and</strong><br />

coarse liver parenchymal<br />

echotexture with multiple<br />

echogenic foci, some with<br />

associated "comet-tail<br />

artifacts" ſt in a patient with<br />

numerous biliary hamartomas.<br />

Hepatic Sarcoidosis<br />

Amyloidosis<br />

(Left) Longitudinal abdominal<br />

ultrasound in a patient with<br />

sarcoidosis shows<br />

hepatomegaly (26 cm length)<br />

<strong>and</strong> heterogeneous liver<br />

parenchymal echogenicity ſt<br />

due to hepatic involvement of<br />

sarcoidosis. (Right) Transverse<br />

abdominal ultrasound in a<br />

patient with amyloidosis<br />

shows heterogeneous <strong>and</strong><br />

coarse liver echotexture ſt<br />

<strong>and</strong> periportal edema st due<br />

to hepatic involvement of<br />

amyloidosis.<br />

871

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