Focal hepatic lesions in concerns of diagnostic imaging

Presented by Dr Laith fadhel

MBchB P.G.C.R

This is summarized notice about the common focal hepatic lesion and its characterization by modality

Reference / Primer of diagnostic Imaging / page 156

Metastasis HCC Adenoma FNH Hemangioma Cyst

40-70 50-70 20-40 20-40 All ages All ages Age

F = M M>F F>>M F>>M F> M M=F Sex

No Occasional Occasional Common In giant No Scar

Rare Rare No No Yes Occasional Calcification

No Yes Yes No Yes ( rare ) Yes (rare ) Rupture

Dx BY

Variable Variable Variable Variable Hyperechoic Anechoic US

Variable Capsule art enhancement

Arterial enhancement

Scar arterial phase

Enhancement early peripheral

Hypo dense No

enhancement

CT

Spleen Liver intensity Liver intensity Liver intensity CSF intensity CSF intensity MRI

Variable Hyper vascular Hyper vascular Hyper vascular Hyper vascular Avascular Angiography

Cold Cold Uptake Uptake Uptake Cold Scintigraphy

cyst US anechoic

CT hypo dense , no enhancement MRI CSF density

Hemangioma US Hyperechoic

CT enhancement early peripheral MRI CSF density

FNH US Variable

CT scar , art phase

MRI liver intensity

Adenoma US Variable

CT , art enhancement MRI liver intensity T1

un enhance

HCC US Variable

CT , pseudocapsule art enhancement early wash out MRI liver intensity T1

un enhance

Metastasis US Variable

CT , variable MRI spleen intensity

T1 un enhance