Clinical evaluation Flashcards
elevated LFTs, no symptoms. Poor transmission , high attenuation
Hepatic steatosis / FL infiltration
Focal echogenic area.
Patch of fatty liver. (No mass effect)
Focal fatty infiltration
Focal hypoechoic area.
Patch of normal liver. Most common location:
next to GB/porta hepatis
Focal fatty sparing
Clinical: Poor liver function symptoms = elevated LFTs, jaundice (elev total or direct
bilirubin), fatigue, weight loss, diarrhea
Sono: heterogeneous/coarse texture, small right lobe, enlarged caudate lobe, nodular
surface, ascites
Cirrhosis
Most common cause is alcoholism.
Cirrhosis
Clinical: SAME as advanced cirrhosis + may have: caput madusa (superficial abd veins) and
GI bleeding
Sono: Hepatofugal PV flow, dilated MPV >13mm, abdominal varices = dilated venous
collaterals near spleen, stomach, and esophagus, abnormal splenic vein flow,
splenomegaly, recanalized paraumbilical vein
Portal Hptn
Most common cause is cirrhosis.
Portal Hypertension
Clinical: Pain, elevated LFTs, hypovolemia, nausea, vomiting
Portal vein compression / thrombosis
most commonly caused by tumors or lymphadenopathy.
Portal vein compression / thrombosis
Sono: Thrombosis of PV, cavernous transformation
Portal vein compression / thrombosis
Clinical: Elevated LFTs
Sono: Hepatomegaly, enlarged caudate lobe, absent flow hepatic veins
Budd-Chiari Syndrome
: No signs of infection. Only evidence of decreased liver function
Hepatitis C
: Fever, non-obstructive jaundice (elevated direct bilirubin), elevated LFTs
Hep a
“Starry sky” sign
Periportal cuffing
Inc echogenicity of portal triads
hep a
Benign/non-endocrine
asymptomatic
Malignant =
symptomatic
Made of fat. Hyperechoic
Lipoma
Associated with oral contraceptives. Varied, may be echogenic
Hepatocellular Adenoma
2nd most common benign liver tumor. “Stealth lesion” because it
may be isoechoic to liver tissue. Central scar with vascularity. Look
for “mass effect”
Focal Nodular Hyperplasia
“Bleed” from trauma or surgery. Clinical: Trauma or Biopsy Hx, decreased hematocrit, pain
Hematoma
Increased risk = chronic liver disease, cirrhosis, hepatitis.
Tumor marker = elevated AFP (alphafetoprotein)
Hepatocellular Carcinoma - HCC aka hepatoma
Clinical: possible abnormal LFTs, pain, jaundice
Sono: multiple masses with variable appearance,
ascites
Metastasis
: Most common. Fold of fundus over body
Phrygian cap
Outpouching of neck
Hartmann pouch
