First set of flash cards
Tumors associated with von hippel-lindau syndrome include:
- renal cell carcinoma
- hemangioma
- Pheochromocytoma
- Pancreatic cystandenocarcinoma
- Adenoma
- Islet cell tumor
- Cyst associated with variety of organs
what tumors commonly imaged with US are associated with von hippel-lindau syndrome
Acute cholecysitits is usually precipitated by a stone obstructing the cystic duct. This situation results in an obstruction of venous drainage, and inflammation of the GB wall with variable degrees of necrosis and infection
Accompanying symptoms of acute cholecystitis are RUQ tenderness, guarding, fever, chills and leukocytosis.
5 sonographic criteria that define acute cholecystitis are
- Gall stones
- sonographic Murphy’s sign
- Diffuse wall thickening
- GB dilatation
- Sludge
Describing acute cholecystitis
what symptoms acompany acute cholecystitis
Name 5 sonographic criteria that define acute cholecystitis
Mycetoma (fungal ball) appear as hyperechoic, non shadowing masses. Angiomyolipomas, blood clots, pyogenic debris, sloughed papilla, and non shadowing renal stones have a similar sonographic appearance
what is the sonographic appearance of a renal mycetoma
Findings associated with renal vein thrombosis
- dilated thrombus- filled renal vein
- Absent intrarenal venous flow
- Enlarged hypoechoic kidney
- High-resistance renal artery waveform (increased RI)
what are sonographic findings associated with renal vein thrombosis
what malignant tumor is associated with urinary collecting system (renal pelvis, ureter and bladder)?
Transitional cell carcinoma, although typically occurring in the bladder, can arise in the ureter and renal pelvis
Pyonephrosis is the presence of pus in a dilated renal collecting system, secondary to infected hydronephrosis
Sono findings 3
- Dependent echoes within dilated pelvocaliceal system
- Shifting urine-debris level
- Gas shadowing from infection
what is pyonephrosis?
what are three sonographic features of pyenophrosis
- Renal enlargement
2. Hypeoechoic parenchyma, and absence of sinus echoes
Us findings associated w significant acute pyelonephritis?
what is the most common childhood renal tumor?
Wilm’s tumor (nephroblastoma) is the most common renal tumor in children. The mean age at diagnosis is 3.5 years
What mass should be suspected when a filling defect is noted in the bladder?
Transitional cell carcinomas arise in the bladder.
Other bladder masses, such as. blood clots or fungal balls have a similar sonographic appearance
All fat-containing tumors have the ability to create a propagation speed artifact. This common sono finding is created because sound travels slower in fat than in soft tissue. Thus a sound pulse in a fat containing tumor is delayed and objects that are behind the tumor are atrifactually placed further from the transducer
common sonographic artifact is demonstrated with renal angiomyolipoma, hepatic lipoma, and adrenal myelolipoma
Renal cell carcinoma sonographically appears as an encapsulated, solid mass that is hyperechoic relative to normal, adjacent renal parenchyma. What additional areas should be evaluated whenever a solid renal mass is detected?
Whenever solid renal mass is detected, additional areas of evaluation should include the:
- Ipsilateral renal vein and IVC for tumor invasion
- Contralateral kidney and renal vein
- Retroperitoneum for lymphadenopathy
- Liver for metastases
Renal cell carcionmas are also called hypernephromas adenocarcinomas or a von growitz tumor
High incidence of renal cell carcinoma is found in association with:
- Adult polycystic kidney disease
- Acquired cystic disease
- Von Hippel-Lindau syndrome
- Tuberous sclerosis
what other names for a renal cell carcinoma?
renal cell carcinoma is associated with what four diseases?
What would a sonographer look for in a PT with history tuberous sclerosis
Tuberous Sclerosis is a multisystemic disorder associated with renal cyst formation and multiple renal angiomyolipomas
Acquired cystic disease is seen with PT’s on chornic hemodialysis. On occasion, these cyst may hemorrhage resulting in flank pain, hematuria and intracystic echogenic collections. Acquired cystic disease is associated w a slightly higher incidence of renal cell carcinoma
What is the term which refers to PT’s on chronic hemodialysis that develop bilateral renal cyst
Name 3 anatomic anomalies that appear as pseudotumors of the kidney
1, Column of Bertin
- Dromedary hump
- Fetal lobation
4 multicystic dysplastic kidney disease include:
- cysts of varying shape and size
- absence of communication between cysts
- absence of renal sinus
- Absence renal parenchyma
Contralateral renal abnormalities associated with unilateral multicystic dysplastic kidney disease include
- Uretopelvic junction obstruction
- Renal agenesis or hypoplasia
- Pelvocalectasis
List four sonographic features of multicysitc displastic kidney disease
What contralateral renal abnormalities are found when multicystic dysplastic kidney disease in unilateral?
what is the most common cause of an abdominal mass in newborn?
Multicysic dysplastic kidney disease in the most common cause of an abdominal mass in the newborn
Medullary sponge kidney is dysplastic cystic dilatation of the collecting tubules of the medullary pyramids
Due to the dysplastic collecting tubules of the medullary pyramids, calcium tends to deposit within them. Thus sono, medullary sponge kidney appears as equally spaced hyperechoic medullary pyramids
What is the medullary sponge kidney
sono appearance of medullary sponge kidney
sonographic findings IPKD appears bilaterally enlarged echogenic kidneys with loss the corticle medullary boundary.
Anomalies associated with IPKD
- Lung hypoplasia
- Periportal hepatic fibrosis, and oligo
Sono appearance of autosomal recessive polycystic infantile kidney disease
Other anomalies associated w infantile polycystic kidney disease
Bilateral enlargement of the adult kidney caused by numerous cysts of varying size is seen with which disease?
Automsomal dominant (adult) PKD presents as bilateral renal enlargement caused by numerous cysts of varying sizes. Associated cysts may also be seen in the liver, pancreas and spleen. ADPKD is also associated with aneurysm development, especially cerebral (berry) aneurysms of the circle of willis
- Round or ovoid shape
- thin wall thickness
- anechoic
- Acoustic enhancement
possible malignant
- Multiple thick septations
- Irregular walls
- large solid components
Sono findings with simple cyst
Sono criteria for an atypical and possible malignant cyst
Hypertrophy of renal cortical parenchyma located between two medullary pyramids. This may five the appearance of a mass effect although the echogenicity is equal to the peripheral cortical tissue.
Column of Bertin
Common anomaly which occur when the renal pelvis protrudes outside the renal hilum sonographically this is seen as a cystic collection medial to the renal hilum
Extrarenal pelvis
Common variant of cortical thickening of the lateral aspect of the left kidney
Dromedary hump
Defect is a triangular echogenic area in the anterior aspect of the RT upper pole of the kidney
Junctional Parenchymal
The most common cause of urinary obstruction in the male neonate. This obstruction results from a flap of mucosa with a slit-like opening in the area of the prostatic urethra
Findings:
Dilated urinary bladder, hydroutreter, hydronephrosis and, possibly, and urinoma
Posterior urethral valves most common cause in male neonates
A duplex kidney is discovered with dilation of the upper pole collecting system. In this situation, is there a partial or complete ureter duplication
W complete duplication of ureters, the ureter draining the upper portion always inserts in an ectopic location in the bladder. A frequent complication of ectopic ureter is a ureterocle, which is prolapse of the distal ureter into the bladder with cystic dilatation. This may extend into the kidney causing dilatation of the upper collecting system. Dilatation of the only the upper pole does not exists with partial ureter duplication
occur when the lower poles fuse and the kidneys ascend in the retroperitoneum. The lower poles are closer to the midline in a U-shaped configuration, opposed to the normal inverted V-shaped. The isthmus is the anterior to the distal abd aorta, and sonographically can mimic lymphadenopathy on a longitudinal image
Horse shoe kidney
Occurs when a kidney ascends to the contralateral side. Both ureters insert into their proper corners of the trigone of the bladder. Thus, the ureter of the kidney that ascended to the contralertal side crosses the midline, Sonographically this appears as two kidneys on one side of the ABD
Crossed renal ectopia
Occurs when the developing kidneys fuse in the pelvis. One kidney ascends to its normal postion and carries the other one W it across the midline. Sonogrpahically, this appears as two kidneys fused at the upper and lower poles on one side of the ABD
Crossed fused renal ectopia
associated with uterine duplication (bicornuate uterus) in females, and seminal vesicle agenesis in males
Unilater renal agenesis
associated with oligo and pulmonary hypoplasia is incompatible with life?
Bilateral renal agenesis
What fascia which encloses the kidneys, adrenal glands and perinephric fat
Gerota’s fascia or the perirenal space
Collecting tubules which appear as hypoechoic triangles in newborns and infants. In adults, they are not commonly imaged, but this depends on PT body habitus
Medullary pyramids
Tracing the renal arteries
The main renal artery branches from the aorta. Upon entering the hilum of the kidney it divides into five segmental arteries, which in turn divide into interlobar Arteries
Tracing the renal arteries
Interlobar arteries are seen between the medullary pyramids. Ast the base of the medullary pyramids, the arcuate arteries branch perpendicular from the interlobar arteries. The arcuate arteries are seen running parallel to the renal capsule
Tracing the renal arteries
Interlobular arteries branch of the arcuate arteries and run perpendicular to the renal capsule
Diaphragm
Quadratus lumborum muscle
Psoas muscle
Posterior to the kidneys
The vein exits anteriorly
The artery enters between the vein and ureter
The ureter exits posteriorly
Structures that enter and exit the renal hilum
- Echogenic thrombus within vessel lumen
- An increase in portal vein diameter
- Portosystemic collateral circulation
- Cavernous transformation
sonographic indications of portal vein thrombosis
Chara by viscous secretions leading to pancreatic insufficiency. When severely affected, what is the sonoraphic appearance of the pancreas in a PT with cystic fibrosis
Cystic fibrosis
Increased echogenicty of the pancreatic parenchyma
the chronic appearance of the pancreas in a PT with cystic fibrosis
True pancreatic cysts are uncommon. Multiple pancreatic cysts are associated with what two syndromes?
Multiple pancreatic cysts are associated with
Autosomal dominant (adult) polycysitc kidney disease and Von hippel-lindau syndrome
What type of hematoma is the result of splenic trauma in which of the splenic capsule remains intact
Intraparenchymal or sub capsular hematoma
What type of hematoma is the result of splenic trauma in which the splenic capsule ruptures
Perisplenic or intraperitoneal hematoma
Peripheral wege-shaped hypoechoic lesion
appearance of splenic infarct
- Cystic degeneration of infarcts or hematomas
- cysts associated with adult polycystic kidney disease
- Parasitic cysts of the spleen (echinococcal cysts)
- Pancreatic pseudocysts
Structures that appear as cystic splenic masses
The stomach is ______ to the splenic hilum
Anterior, medial
Tail of the pancreas is _____ to the stomach
Posterior
The left kidney is _____ to the spleen
Inferior and medial
The tail of the pancreas is _______ to the upper pole of the LT kidney
Anterior
- Breakdown of hemoglobin
- Formation of bile pigment
- Formation of antibodies
- A reservoir of blood
The 4 functions of the spleen
Collections of pancreatic fluid encapsulated by fibrous tissue
Pancreatic Pseudocysts
- Acute pancreatits
- chronic pancreatitis
- Trauma, and
- Pancreatic cancer
Pancreatic pseudocysts are cuased by?
Commonly located within the anterior pararenal space of the retorperitoneum and the lesser sac of the peritoneum
most common location of a pancreatic pseudocysts
- Pituitary adenoma
- Parathyroid adenoma
- Medullary thyroid carcinoma
- Pancreatic islet cell tumors
- Pheochromocytoma
- Ganglioneuromatosis
Six tumors that are associated with Multiple Endocrine Neoplasia Syndrome
small, well circumscribed masses, usuallly found within the pancreatic body and tail
Most common benign tumors of the pancreas, but they can also be malignant
Islet cell tumors
Two most common types of Islet cell tumors
Insulinoma and gastrinoma
Chara by hyperinsulinsim and hypoglycemia
Insulinoma
Associated with gastric hypersecretions and peptic ulcer disease (zollinger-Ellsion syndrome)
Gastrinomas
What does the celiac axis divide into?
LT gastric, common hepatic and splenic arteries
Branches of common hepatic artery
hepatic proper and the gastroduodenal arteris
what two veins join to form the main portal vein
Superior mesenteric vein and splenic vein
The pancreas is a nonencapsulated, rerperitoneal structure located between the second portion of the duodenum and the splenic hilum. What space in the retroperitoneum is the pancreas located?
Anterior pararenal space of the retroperitoneum
5 different parts of the pancreas
Head, Neck, Body, Tail and uncinate process
Endocrine function of the pancreas
Islet cells of Langerhans which secretes insulin
Commonly seen in the hilum of the liver, as this is the direction of bile flow
Pneumobilia
Chara by variable length echogenic foci in the distribution of the biliary tree, resulting in acoustic shadowing and reverberation ( Comet tail) artifacts
Sonogrpahically, Pneumobilia
- Two cyst-like structures in the RUQ These are the gallbladder and the dilated common bile duct
- Dilated intrahepatic biliary tree
Choledochal cysts
Usually occur in Asian women
Symptoms of pain, jaundice and an abdominal mass may be present.
Choledochal cysts
chara sonographically by saccular, communicating intrahepatic bile duct dilatation
Caroli’s disease
Associated with
- IPKD
- Congenital hepatic fibrosis
- Choldeochal cysts
Caroli’s disease
Is enlarged, non diseased GB, associated with an extrinsic obstruction (i.e. pancreatic carcinoma) of the distal common bile duct
Courvoisier GB
Presents as a fluid-fluid level that produces acoustic shadowing
Milk of calcium bile
Uncommon cancer, ulcerative colitis, sclerosing cholangitis, caroli’s disease, choledochal cyst, and parasitic infestations
Bile duct carcinoma
cholangiocarcinoma
Commonly located in the CHD and CBD. A klatskin tumor is specific type. Located at the hepatic hilum. With Klatskin tumor intrahepatic bile duct dilatation should be seen without extrahepatic
Cholangiocarcinoma
The head of the pancreas is _____ to the IVC
anterior
The head of the pancreas is ______ to the second portion of the duodenum
Medial
The common bile duct is ____ to the head of the pancreas
Posterior lateral
The Gastroduodenal artery is ____ The head of the pancreas
Anterior lateral
The superior mesenteric artery and vein are ______ to the neck of the pancreas
posterior
The uncinate process is ______ to the Superior mesenteric artery and vein
Posterior
The arota _____ to the body of the pancreas
Posterior
The celicac axis arises from the arota ___ to the pancreas
superior
The gastroduodenal artery and common bile duct run _____ To the first portion of the duodenum
posterior
The splenic vein is ___ to the pancreas
posterior
The superior mesenteric artery arises from the arota ____ to the pancreas
inferior
The superior mesenteric artery and vein are ______ to the uncinate process of the pancreas
anterior
the superior mesenteric artery and vein are _____ to the third portion of the doudenum
anterior
The superior mesenteric vein is to the ______ of the superior mesentreic artery
right
The portal vein is the result of the combination of the _____ and the ______
superior mesenteric vein and the splenic vein
What are two most common causes of pancreatitis?
alcohol abuse and biliary calculi
diagnosed with clinical and laboratory findings. On sonography may demonstrate a normal pancreas. With increasing severity, decreased echogenicity and increased gland size and noted
sonographic findings with acute pancreatitis?
Progressive, irreversible destruction of the pancreas.
- small echogenic gland
- calcification’s
- pancreatic duct dilation
- pseudocyst formation
Sonographic signs of chronic pancreatitis?
Sonogrpahically seen as a solid focal hypoechoic mass typically (70%) in the head of the pancreas.
Pancreatic adenocarcinoma
what sign is associated with an adenocarcinoma of the pancreatic head resulting in extrinsic compression of the common bile duct and an enlarged gallbladder
Courvoisier’s sign
- Dilated biliary system
- dilated pancreatic duct
- Liver metastases
- ascites
- lymphadenopathy
- pseudocyst formation
Additional findings with adenocarcinoma pancreatic
1, common hepatic duct
- cystic duct
- common bile duct
Three extrahepatic biliary ducts
Klatskin tumor causes intrahepatic biliary dilatation without extrahepatic biliary dilatation.
The pathology that causes intrahepatic biliary dilatation w/o extrahepatic biliary dilatation
Is an extrahepatic bile duct obstruction due to a stone within the cystic duct. The stone causes extrinsic mechanical compression of the common hepatic duct
Mirizzi’s syndrome
Sono findings include intrahepatic bile duct dilatation, a normal-sized CBD, and a large stone in the cystic duct of the gallbladder
Sono findings with Mirizzi’s syndrome
What are two signs that indicate intrahepatic bile duct dilatation
Shot gun sign and parallel channel sign both describe the appearance of a dilated bile duct adjacent to a portal vein. Other is Stellate or star-shape
Two most common causes of biliary tract obstruction?
- gallstones (choledocholithiasis)
2. Carcinoma of the pancreas
- alkaline phosphatase (elevated)
- conjugated (direct) bilirubin (elevated)
- gamma glutyml transpeptidase (elevated)
Lab values elevated due to biliary tract obstruction
Uncommon, present as an intraluminal mass, asymmetric wall thickening or a mass-filled gallbladder
sono finding with gallbladder carcinoma?
- Liver metastases
- lymphadenoapthy
- bile duct dilation
Other sono findings for gallbladder carcinoma
What is Rokitansky-Ascholff sinuses (RAS)?
diverticula within the wall of the gallbladder
what pathology is associated with Rokitansky-Ascholff sinuses (RAS)?
Adenomyomatosis . Sludge and stones accumulate within the sinuses, and present as a focal wall thickening
Causes characteristic comet tail reverberation artifact
Distended, non inflamed gallbladder due to total obstruction of the cystic duct. The trapped bile is reabsorbed and the gallbladder is filled with a clear muscinous secretion derived from the mucosa.
The mechanism of hydrops of the gallbladder
About gallbladder hydrops
asymptomatic and may present as a palpable, RUQ mass. The diagnosis should be suspected on US when obstructing stone is noted in an enlarged, but non-tender, gallbladder
what is emphysematous cholecysistis
an infection associated with gas-forming bacteria within the wall of the gallbladder
Sono findings of emphysematous cholecysistis
gas shadowing from the wall for the gallbladder
Three lobes of the liver
- Rt lobe
- Lt lobe
- caudate lobe
- Caudate
- Lt lateral superior segment
- Lt later inferior segment
- Lt medical superior segment
- Lt medical inferior segment
- Rt anterior superior segment
- Rt anterior inferior segment
- Rt posterior superior segment
- Rt posterior inferior segment
The segments of the liver
Universal system of liver segmentation used for hepatic lesion localization. It is based on the functional distribution of portal veins. Each segment has its own hepatic artery, portal vein and bile duct
Couniaud’s Anatomy
Which portion of the liver receives both Rt and Lt portal branches
Caudate lobe Also drains into the inferior vena cava via the emissary veins
The liver’s covering is called_____ what is another term for the covering
Glisson’s capsule and is also visceral peritoneum
The lining of the abd cavity
Parietal peritoneum
Hepatopetal
portal vein flow toward the liver is termed hepatopetal
Hepatofugal
Portal vein flow away from the liver is termed hepatofugal
Hyperechoic-
echogencicity that is greater than reference structure
Hypoechoic-
Echogenicity that is less than reference structure
Anechoic (sonolucent)
absence of echoes
Isoechoic-
Echogenicity that is equal to the reference structure
Abdominal structures from hyperechoic to hypoechoic is:
Renal sinus
Pancreas
Liver/spleen
Renal cortex
Which vessels are considered to be intersegmental within the liver?
Thin walled hepatic veins
Which vessels are considered to be intrasegmental within the liver
The portal vein, hepatic artery and bile duct course together into the center of each hepatic segment. These three vessels form the portal triad.
incomplete boundary which can be located by an imaginary line from the gallbladder fossa to the IVC. This boundary separates the Rt and Lt Lobes of the liver and the middle hepatic vein is a landmark of this fissure
Main lobar fissure
which two segments of liver does the main lobar fissure separate
Rt anterior segment of the Rt lobe from the Lt medical segment of the Lt lobe
Is a coronal division of the Rt lobe of the liver. It divides the Rt lobe into the anterior and posterior sections. The Rt hepatic vein is a landmark of the right intersegmental fissure
Rt intersegmental fissure
sagittal division of the Lt lobe of the liver. It divides the Lt Lobe into medial and lateral sections. The hepatic vein, ligamentum teres, falciform ligament and the ascending segment of the Lt portal vein are landmarks of the intersegmental fissure
Lt intersegmental fissure
Remenant of the ductus venosus, which prenatally conucts blood from the Lt portal vein to the IVC. The ligamentum venosum and the prox portion of the LT portal vein separate the medial segment of the Lt lobe of the liver from the caudate lobe
Ligamentum Venosum
Posteriorly by the IVC
Anteroinferiorly by the prox LT portal vein
Anterolaterally by the ligamentum venosum
Inferiorly by the main portal vein
The caudate lobe boundaries
Posterior, crescent-shaped portion of the liver which is not covered by the pertioneum
Bare area
Reflection of the parietal peritoneum onto the liver surface, becoming the visceral peritoneum
Coronary ligament
Reflections, or coronary ligaments, at each corners of the bare area are termed the
Rt and Lt triangular ligaments
Liver anomaly that is more common in women then men. Seen as the Rt love of the liver extending beyond the lower pole of the Rt kidney, Increases the superior/inferior dimension
Reidel’s lobe
Enlarged Lt lobe measures greater than 15.5 cm
Hepatomegaly
Usually solitary, and occur in the Rt lobe of the liver. They are caused by bacteria which reach the liver via the bile ducts, portal veins, hepatic arteries or lymphatic channels
Pyogenic Abscesses
Appears as Hypoechoic, rounded, fluid-filled masses with variable degrees of internal echoes or debris. As with any abscess, echogenic foci may be seen as a result of gas-producing organisms
Sono findings for pyogenic abscesses
sono is (starry night sign)
Hypoechoic liver paranchyma
Liver enlargement
Hyperechoic portal vein walls
Acute hepatitis
Sono is Hyperehcoic liver parenchyma
Small liver
Decreased echogenicity of portal vein walls
Chronic hepatitis
Due to protozoan parasites, entamoeba hystolytica, which enter the intestinal tract and reside in the colon. The amoebae may extend into the liver via the portal vein. Most amoebic abscesses occur in the Rt love of the liver the indirect hem agglutination test is used for diagnosis
Amoebic abscesses
Round oval-shaped hypoechoic mass
Absence of prominent wall
Fine low-level internal echoes
Distal enhancement
contiguous with diaphragm
Amoebic abscess sono appearance with in the liver
Prevalent in sheep and cattle raising countries. Humans occasionally the hosts when the eggs are ingested. The embryos travel from the gastrointestinal tract to the liver, viz the portal vein.
Hydatid disease
large (pericyst) cyst, containing one or more smaller daughter cysts (endocysts). Fine internal echoes (hydatid sand) are also found within these cysts.
Sono appearance of the echinococcal cyst
Most common parastic infections worldwide (Africa and South America). What is the most significant vascular event associated with this?
Schistosomiasis
Intrahepatic portal vein occlusion by the larvae, leading to portal hypertension
appears as distended, echogenic debris-filled intrahepatic portal veins
sono findings with Schistosomiasis
what is the most common organism causing infections in AIDS and other immuncompromized patients
Pneumocystis carinii
Involvement of the liver is seen as non shadowing echogenic foci
sono pneumocystis carinii
Regions of increased echogenicity present within a background of normal liver parenchyma.
sono of fatty infiltration
Islands of normal liver parenchyma, which appear as hypoechoic masses within a dense fatty infiltrated liver. Focal fatty sparing commonly seen adjacent to the gallbladder.
Focal Fatty sparing
Results in large quantities of glycogen being deposited in the hepatocytes of the liver and convoluted tubules the kidney.
Glycogen storage
What liver mass is associated with glycogen storage disease
Hepatic Adenomas
Linked to usage of oral contraceptive agents. Due to the increase incidence of tumor hemorrhage and risk of malignant transformation, surgical resection is usually recommended. It is difficult to distinguish from focal nodular hyperplasia
Hepatic adenomas
Hepatocelluar death, fibrosis and regeneration are the three pathological mechanisms of cirrhosis
three pathological mechanisms of cirrhosis
Classic clinic presentation of cirrhosis
hepatomegaly, jaundice and ascites
Clinical signs of portal hypertension are
ascites, splenomegaly and varices
has been associated with hepatocellular carcinoma, metastatic liver disease, pancreatic carcinoma, and pancreatitis
Portal vein thrombosis
intraluminal thrombus
increased vein diameter
Cavernous transformations
Sono findings of portal vein thrombosis
Budd-Chiari Syndrome
characterized by occlusion of the hepatic veins
hepatic vein thrombosis
ascites
hepatomegaly- acute phase
caudate lobe enlargement-chronic phase
portal hypertension
sono findings of Budd-Chiari
Most common benign tumors of the liver
Cavernous hemangiomas
appears as a small well-defined, hyperechoic mass with possible posterior acoustic enhancement
Cavernous Hemangioma sono finding
is a common benign liver mass
Focal Nodular hyperplasia
Solitary mass, usually less than 5 cm in diameter, that may have a central fibrous scar.
Focal Nodular hyperplasia
Hemangioimas, hepatic lipomas, echogenic metastasis and focal fatty infiltration
well defined hyperechoic liver masses
