Clinical significance of focal echogenic liver lesions

Abstract

During a 4-year period, 53 focal echogenic liver lesions were demonstrated by sonography in 41 patients, in whom there was no evidence of metastatic origin. Most of the lesions were hemangiomas. One of the purposes of this study was to determine the characteristic ultrasound features for liver hemangioma. Small (less than 2 cm), homogeneous, echogenic, well-circumscribed, subcapsular lesions almost prove their hemangiomatous nature. Lesions with a diameter of more than 2 cm are usually more lobulated and heterogeneous. They are located more centrally in the liver and nearly all show a close anatomical relation with 1 of the hepatic veins. Very large lesions (greater than 5 cm) with a heterogeneous and irregular aspect suggest focal nodular hyperplasia, which must be proven by a Tc-isotopic liver scan.

Neural Network Ensemble Based CAD System for Focal Liver Lesions from B-Mode Ultrasound

“…Even then, B-mode US is the first choice for characterization of FLLs mainly due to its non-radioactive, non-invasive, inexpensive nature and real time imaging capabilities [5][6][7]. In comparison to B-mode US, other imaging modalities like, contrast enhanced US, contrast enhanced spiral computed tomography (CT) and magnetic resonance imaging (MRI) offer high sensitivity for characterization of FLLs, but these imaging modalities are expensive, pose greater operational inconvenience and are not widely available [1,5,6,[8][9][10][11][12][13].…”

“…Typical FLLs can be easily diagnosed by radiologist from their classic sonographic appearances, but differential diagnosis in the presence of atypical FLLs is considered to be a daunting challenge faced by the radiologists during routine practice [7,9,11,[14][15][16][17].…”

“…Typical Cyst appears as round, anechoic lesion with posterior acoustic enhancement and well defined thin imperceptible wall [5,9,10,21]. HEM is the most common primary benign FLL [1,7,9,17,22]. Almost 70 % of all the HEM cases encountered in routine practice are typical HEMs.…”

“…Typical HEM appears as a well circumscribed uniformly hyperechoic lesion [5,9,10,15,[21][22][23]. MET is the most common secondary malignant FLL [2,7,9,[21][22][23]. MET may occur singly or as multiple deposits of varying sizes.…”

“…MET may occur singly or as multiple deposits of varying sizes. The typical sonographic appearance of MET lesion is the 'target' or 'bull's-eye' appearance (i.e., hypoechoic center surrounded by a hyperechoic rim) [2,5,7,15,16,21,22,24]. The sample images for NOR liver and typical cases of Cyst, HEM and MET lesions are shown in Fig.…”