Diagnostic Ultrasound - Abdomen and Pelvis

Hepatic Mass With Central Scar
Focal Nodular Hyperplasia
Focal Nodular Hyperplasia
(Left) Axial arterial phase T1
contrast-enhanced MR shows
a hyperenhancing FNH ſt,
which is hyperintense
compared to adjacent liver
parenchyma . Hypointense
stellate central scar st is
characteristic of FNH. (Right)
Axial hepatobiliary phase MR
obtained 20 minutes after
gadoxetate injection in the
same patient shows the FNH
retains contrast to slightly
greater degree ſt than the
background liver ,
confirming the presence of
hepatocytes in the FNH.
Differential Diagnoses: Liver
Fibrolamellar Carcinoma
Hepatocellular Carcinoma
(Left) Transverse grayscale US
of the liver shows a large,
predominantly echogenic mass
st with a thick, hypoechoic
central scar . The mass was
proven to be a fibrolamellar
carcinoma. (Right)
Intraoperative grayscale
ultrasound of the liver shows a
large, heterogeneous,
isoechoic hepatocellular
carcinoma ſt with hypoechoic
central scar st.
Hepatic Metastases
Atypical Hemangioma
(Left) Oblique abdominal
grayscale US in a patient with
melanoma shows a large,
heterogeneous, hyperechoic
metastasis ſt in the right lobe
of the liver. Central
hypoechoic areas simulate a
central scar . (Right)
Longitudinal grayscale
abdominal US shows a
hyperechoic hemangioma in
the liver ſt. The ill-defined
hypoechoic area in the center
simulates a central scar.
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