Ultrasound of focal liver lesions

Abstract

This paper gives a comprehensive overview of ultrasound of focal liver lesions. Technical aspects such as examination technique and the use of Doppler modes as well as recent developments such as tissue harmonic imaging and microbubble contrast agents are discussed. The clinical significance and sonographic features of various liver lesions such as haemangioma, focal nodular hyperplasia, adenoma, regenerative nodule, metastasis, hepatocellular carcinoma and various types of focal infections are described. With the exception of cysts and typical haemangiomas, definitive characterisation of a liver lesion is often not possible on conventional ultrasound. This situation has changed with the recent advent of ultrasound contrast agents, which permit definitive diagnosis of most lesions. Contrast-enhanced sonography using recently developed contrast-specific imaging modes dramatically extends the role of liver ultrasound by improving its specificity in the detection and characterisation of focal lesions to rival CT and MRI.

Diagnostic Performance of Imaging in Detection and Characterization of Liver Lesions

“…Liver cysts were identified and confidently diagnosed, and a variety of appearances of solid masses suggested a specific diagnosis. Recognition of a hypoechoic halo or rim surrounding an echogenic or isoechoic liver mass, suggested probable malignancy, this was also been mentioned in previous studies [52,53] and masses with this morphologic characteristic were provoked confirmatory imaging with computed tomographic (CT) scans ,some showed similar findings and another showed different results as presented in table (7) .Multiple hypoechoic masses in the liver most often suggest metastases. [54]This was seen in our results and it was also diagnosed well in the contrast enhanced CT scans.…”

Liver haemangioma: common and uncommon findings and how to improve the differential diagnosis

“…1b) consists of the demonstration of a homogeneous hyperechoic liver nodule, with discrete posterior acoustic enhancement, devoided of Doppler signal both on colourcoded and spectral examination [11].…”

“…In patients with a known malignancy, and with previous normal examinations, or in cases of atypical imaging presentation, the diagnosis needs to be confirmed by other means beyond US, ultimately leading to the use of invasive techniques [11]. Less typical imaging findings of haemangiomas can result from three main causes: altered morphology or structure, unusual flow patterns or associated liver abnormalities.…”

Surgical hepatic resection vs. ultrasonographic guided radiofrequency ablation in colorectal liver metastases: what should we choose?

“…Conventional transabdominal ultrasound has been successfully used in detecting liver masses and has cer- Solitary liver colorectal cancer metastases of 2.88 cm in diameter; CEUS after one month revealed a RFA area of about 3.9 cm/4.5 cm ; a) before RFA; b) after RFA; c) CEUS one month after RFA tainly improved over the past years by introducing microbubble ultrasound contrast agents (UCA), that provide a more specific diagnostic and characterization of liver tumors [16]. As a guiding procedure for RFA, US examinations still have its advantages as compared to computer tomography (CT) or magnetic resonance (MR), based on the worldwide availability, ease of use, no radiation exposure and low cost characteristics.…”