Liver Flashcards
What are the findings of acute and chronic hepatitis?
Acute:
Hepatomegaly, decrease echogenecity
Starry sky appearance
Periportal hypoechoic
Chronic:
Increased echogenecity
Cirrhosis
Diagnostic checklist of hepatitis
Rule out other causes of hepatomegaly
Hepatomegaly and portal oedema present
US findings of cirrhosis
Nodular contour
Coarse echotexture
Regenerative hypoechoic nodule
Size varies in course
Enlarged caudate and lateral left
Atrophy of right lobe and medial left
Portal hypertension
Checklist for cirrhosis
Rule out other causes of nodular dysmorphic liver
US findings of hepatic steatosis
Increased echogen
Increase in size
Posterior acoustic attenuation
If focal - R, caudate lobe/perihilar region
US findings of parenchymal calcification
Hyperechoic
PAS
US findings of diffuse microabscesses
Multiple small lesions differ in echo
Target sign
Wheel within wheel
US findings of lymphoma
Multiple well defined nodules/masses
Hypoechoic/anechoic
May mimic abscess
Septae
Periportal areas
Associated splenomegaly, LN
Diagnostic checklist of lymphoma
Rule out cysts, abscess, hemangioma
Associated splenomegaly and LN
Confirm with needle biopsy
Us findings of hepatic cyst
Anechoic (PE)
Beneath liver surface
Unilocular with thin smooth wall
May loculate or septa
Norma parenchyma
Diagnostic checklist of cyst
Rule out cyst like lesions - infection, neoplasm
Anechoic, thin wall, PE
US finding of hepatic abscess
Cluster sx
Spherical or ovoid
Echo/border/wall non specific
Fluid level, internal septae, PAE
Diagnostic checklist for abscess
Cluster sx
Specific - central gas, fluid level
Rule out amebic, fungal abscess or cystic tumours
Us findings of adenoma
Heterogenous, hypervascular mass
Young woman
Usually subcapsular region of right lobe
8 to 10cm
Well defined
Echo non specific
Checklist for adenoma
Rule out other tumors esp HCC FNH
US findings of FNH
Spoke wheel pattern
May mimic fibrolamellar HCC - large lesion more than 12 cm with calcification and mets
US findings of HCC
Large hetero mass with vascular invasion
More on R lobe
Mostly hypoechoic
Mixed echo if larger
Checklist for HCC
Any mass in cirrhotic liver HCC until otherwise
Hypervascular mass invading portal vein
US findings of hepatic haemangioma
Well defined uniformly hyperechoic mass
Displaces but not infiltrate vessels
Smooth borders
US findings of hepatic mets
Multiple lesions random distribution
Round or oval with smooth or irregular borders
No vessel invasion
Most hypovascular
Checklist of hepatic mets
Rule out abscesses, cysts, haemangioma
Target lesion points to mets or HCC
US findings of portal hypertension
PV more than 13 mm
Hepatic cirrhosis
Reverse flow in portal veins
Checklist for portal hypertension
PV dilated with splenomegaly and no underlying causes
