Diagnostic Ultrasound - Abdomen and Pelvis

Multiple Hepatic Masses
Cirrhosis With Regenerative/Dysplastic
Nodules
Hepatocellular Carcinoma
(Left) Abdominal US in a
patient with hepatitis B shows
numerous small hypoechoic
nodules in the liver ſt,
indicating regenerative or
dysplastic nodules. Coarse and
heterogeneous echogenicity of
liver parenchyma is consistent
with underlying cirrhosis .
(Right) Abdominal US shows
multifocal hypoechoic HCCs
ſt throughout the liver. The
right portal vein is thrombosed
and filled with echogenic
material that was found to
represent tumor thrombus st.
Differential Diagnoses: Liver
Pyogenic Hepatic Abscess
Hepatic Microabscesses
(Left) Transverse abdominal
grayscale US shows multiple
hepatic abscesses ſt in the
liver, seen as ill-defined
isoechoic masses surrounded
by thin hypoechoic rims. A
small amount of perihepatic
ascites is present as well.
(Right) Longitudinal
abdominal grayscale US shows
multiple small hypoechoic
fungal microabscesses ſt in
the right lobe of liver.
Hepatic Echinococcus Cyst
Caroli Disease
(Left) Transverse abdominal
ultrasound shows an
echinococcal cyst containing
multiple peripheral daughter
cysts ſt and heterogeneous
material centrally st. Note
the associated posterior
acoustic enhancement .
(Right) Oblique abdominal
ultrasound in a young patient
with Caroli disease shows
multiple dilated intrahepatic
ducts . Echogenic portal
radicles st are surrounded by
dilated ducts. Some of the
portal radicles within dilated
ducts show color flow ,
which creates the "central
dot" sign appearance.
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