Lectures

Focal liver lesion: nonlinear contrast-enhanced ultrasound imaging

Enhancement Patterns of Benign Focal Lesions

Regenerative Nodule

Regenerative nodules are found in liver cirrhosis surrounded by fibrous septae. The nodular dimension characterizes the micro-macro or mixed type of cirrhosis evolution. Large regenerative nodules from 5 to 20 mm can be detected on conventional US as hypo-echoic nodular lesions; hyper-echoic patterns due to fatty change are rarer. Color Doppler or CEUS real-time vascular evaluation show no apparent vessels in lesions (Migaleddu et al., 2004; Nicolau et al., 2006):

  • Typical features:
    • Arterial phase: iso-enhancing;
    • Portal Vein phase : iso-enhancing;
    • Parenchymal phase: iso-enhancing.
  • Additional features:
    • Arterial phase: hypo- or hyper-enhancing;

Case A-4.1

Focal liver lesion in segment 8, solid hyperechoic. In early arterial phase it is not found enhancement or intralesional microvessels. In portal and parenchymal phase early gradual enhancement without pathological wash out. C.R: regenerative nodules

Case A-4.2

Focal liver lesion in segment 6,7,5 solid hyperechoic. In early arterial phase it is not found enhancement. In late arterial phase show a central arterial vessel. In portal and parenchymal phase homogeneous enhancement regarding the surrounding parenchyma. it is not found pathological wash out C.R: regenerative nodules