Diagnostic Ultrasound - Abdomen and Pelvis

Cystic Liver Lesion
Differential Diagnoses: Liver
(Left) Oblique transabdominal
color Doppler ultrasound
shows a centrally cystic
hepatic abscess ſt with
surrounding hypoechoic
hepatic parenchyma in the
right lobe of liver. Central
internal septations st and
echogenic debris are seen
within the hepatic abscess.
(Right) Transverse color
Doppler US of the liver shows
a biloma in a resection
cavity with peripheral
echogenic foci ſt and ringdown
artifact related to
surgical clips. A small amount
of internal debris is seen in the
periphery of the biloma .
Pyogenic Hepatic Abscess
Biloma
(Left) Transverse grayscale US
of the liver shows 2 adjacent
well-defined tubular shaped
anechoic lesions in the
right lobe of the liver. (Right)
On color Doppler US in the
same patient the lesion is
found to represent a vascular
structure , which drains into
the middle hepatic vein ſt.
Color Doppler US should
always be used to evaluate
anechoic appearing lesions as
they may in fact be vascular,
as in this case of a
spontaneous intrahepatic
portosystemic shunt.
Vessels
Vessels
(Left) Transverse grayscale US
of the liver shows a biliary
cystadenoma with
sonographic imaging
appearance of a complex cyst
with multiple septations
ſt. Most biliary cystadenomas
are seen in middle-aged
females. (Right) Transverse
abdominal US shows an
echinococcal cyst containing
multiple peripheral daughter
cysts ſt and central
heterogeneous content st in
the left lobe of the liver.
Associated posterior acoustic
enhancement is seen.
Biliary Cystadenoma/Cystadenocarcinoma
Hepatic Echinococcal Cyst
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