Diagnostic Ultrasound - Abdomen and Pelvis

Irregular Hepatic Surface
Subcapsular Hepatic Neoplasm
Subcapsular Hepatic Neoplasm
(Left) Transverse grayscale
ultrasound of the liver shows
an isoechoic liver metastasis
from breast cancer that
bulges and slightly distorts the
liver surface. Multiple other
subtle hypoechoic breast
cancer metastases are seen
throughout the rest of the
liver ſt. (Right) Transverse
grayscale ultrasound of the
liver shows a large isoechoic
mass in the caudate lobe of
the liver which creates a
rounded bulge upon the
hepatic surface in this area.
This mass was a focal nodular
hyperplasia (FNH) .
Differential Diagnoses: Liver
Hepatic Metastasis
Infiltrative Hepatocellular Carcinoma
(Left) Transverse grayscale
ultrasound of the left lobe of
the liver in a patient with
breast cancer shows markedly
irregular and nodular liver
surface due to diffuse hepatic
involvement with metastases
. (Right) Transverse color
Doppler ultrasound in a
patient with infiltrative HCC
throughout the liver shows the
infiltrative tumor causes both
markedly heterogeneous
echotexture as well as
irregular hepatic surface .
Hepatic Rupture
Schistosomiasis
(Left) Transverse color
Doppler image in a patient
with liver rupture from HELLP
syndrome shows a large
amount of perihepatic and
subcapsular blood which
causes the liver margin to
appear irregular. Acute blood
can be so echogenic that the
liver margin can be obscured
by the blood. (Right)
Transverse grayscale
ultrasound of a patient with
schistosomiasis and periportal
fibrosis as well as hepatic
capsular irregularity is
shown. (Courtesy W.Chong,
MD.)
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