Lectures

Focal liver lesion: nonlinear contrast-enhanced ultrasound imaging

Enhancement Patterns of Benign Focal Lesions

Cyst

Simple bile cysts are most common liquid benign lesions (1-18%), and are spread throughout the world (Mirilas and Skandalakis, 2002). Hydatid cysts are not uncommon in countries where sheep-breeding is practiced. Conventional US findings (typical anechoic lesions with posterior enhancement) are specific for diagnosis. A nonvital parasitic cyst with solid aspect may be mistaken for tumor; on color Doppler flow signals are absent. Contrast-enhanced ultrasound findings are as follows:

  • Typical features:
    • Arterial phase: non-enhancing;
    • Portal Vein phase: non-enhancing;
    • Parenchymal phase: non-enhancing.
  • Additional features:
    • Parenchymal phase: increased ultrasound transmission.

Case A-5.1

Subcapsular liver lesion in segment 4, solid hypoechoic. Non evidence of enhancement in arterial, portal and parenchymal phases. C.R: CYSTS TO DENSE FLUID CONTENT.

Case A-5.2

Liver lesion in segment 2-3, solid hypoechoic with polylobate margins. Non evidence of enhancement in arterial, portal and parenchymal phases. C.R: involute idatic cyst