abdominal ultrasound Archives - abcofradiology.com

Liver hemangioma ultrasound is an important part of sonographic evaluation of focal liver lesions. However, hepatic haemangiomas usually appear well defined and homogenous, with a characteristic of hyperechoic appearance. Atypical appearance can make diagnosis difficult. Hence, the evaluation of echogenicity, margins, size, Doppler vascularity and background liver are essential for proper interpretation and reporting What is liver hemangioma? The most common benign vascular liver lesions are hepatic hemangiomas or hepatic malformations. Additionally, they are not usually associated with any symptoms. Therefore, it’s important to differentiate hemangiomas from other hepatic malignancies in a sonography setting. Prevalence: 0.4% - 20% of the general population. Number: most are solitary Location: usually found in the right lobe of liver Clinical features of hemangioma: Most of liver hemagiomas cause no symptoms, and doctors detect them incidentally during ultasound or other imaging Typically they usually appear at any age but are more common in adults (30-50) and more common in females (M:F 5:1). Additionally, hormonal factors can affect the behaviour of lesions: some patients have had an increase in the size of hemangiomas with estrogen exposure (during pregnancy/ooestrogen therapy) If symptoms appear may include: Right upper quadrant pain Reduced appetite Early satiety Abdominal fullness Nausea or vomiting Case spotlight: A 26-year-old female comes to the radiology department with complaints of upper abdominal pain associated with nausea and vomiting. Clinicians requested abdominal ultrasound to investigate her symptoms. Ultrasound findings: Liver is normal in size, with mildly inversed echogenicity of liver parenchyma suggestive of hepatic steatosis. A well-defined, homogenous, smooth-margined and predominantly hyperechoic focal liver lesion was noted within the liver. Mild posterior acoustic enhancement was noted. No colour flow was seen on CDI. Opinion: Ultrasound features are suggestive of hepatic hemangioma What does liver hemangioma look on ultrasound? Ultrasound is frequently the first imaging modality to be used to assess focal liver lesions; however, its availability, non-invasiveness and ability to assess the liver parenchyma in real time. On ultrasound, a typical liver hemangioma will show the following characteristics: Echogenicity: homogenous and hyperechoic to the adjacent liver Margins: well defined, helps to differentiate it from poorly defined focal lesions Shape: round or oval, most of time Echotexture: usually uniform, especially in small lesions; however, larger hemangiomas may develop into heterogeneous tumours. Posterior features: however, posterior acoustic enhancement may be present. Size: therefore, the majority of hemangiomas are small, usually less than 3 cm. But does every liver hemangioma have this classic ultrasound appearance? Not necessarily. Although most typical lesions demonstrate characteristic sonographic features, larger or complicated hemangiomas may appear differently. Therefore, distinguishing typical from atypical findings is essential for accurate interpretation. Liver hemangioma on color Doppler: However, Hepatic hemangioma typically show no internal blood flow on colour Doppler ultrasound because blood flow inside the hemangioma is extremely slow. Sometimes colour Doppler may show the small feeding blood vessels around the other edge (peripheral blood flow) What does hepatic hemangioma look on ultrasound when patients have fatty liver? Hepatic steatosis has become more common in recent years. However, Hepatic steatosis making the background of liver brighter than usual. Therefore, in these cases, hepatic hemangioma seem less echogenic and hypoechoic then surrounding liver. Frequently asked questions: 1-is it possible for liver hemangioma to be hypoechoic? Yes. There are atypical appearances, especially related to the characteristics of the lesions and background liver. 2- Is there blood flow within a liver hemangioma on Doppler? Usually little or no detectable internal flow is seen on conventional Doppler. 3- On ultrasound, what does a liver hemangioma appear as? Usually a well-defined, homogeneous hyperechoic lesion 4-Is it possible to diagnose liver hemangioma by ultrasound? A typical lesion in a suitable clinical context can be confidently diagnosed on ultrasound, and if the lesion is atypical, further imaging may be necessary. 2089

Tag: abdominal ultrasound

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