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Case of the Month

December 2010

Patient Data: 44 year old female

Clinical Info: Incidentally found abnormal liver

Transverse image of the liver. The liver has multiple small hyperechoic lesions

Another image of the same liver with multiple hyperechoic lesions

Another image of the same liver

High frequency image of the lesions

36420-01.wmv.SWF CT scan of the liver prior to intravenous contrast

36421-04.wmv.SWF CT scan of the liver after intravenous contrast early (arterial) phase

36422-05.wmv.SWF CT scan of the liver after intravenous contrast portal venous phase. The lesions show no enhancement. This rules out metastases and hemangiomas

The following images also show incidentally found hyperechoic lesions in a 47 year old female

High frequency image of another lesion in the same liver

High frequency image of other lesions in the same liver. Although the lesions are less dense and less numerable than in the first patient. In both cases the diagnosis proved to be the same.

The multiple small hyperechoic lesions proved to be focal fatty changes. Fatty changes in the liver can have many appearences. Focal areas of increased echogencity are not uncommon, but multiple well defined round lesions as in these two cases are less common. The differential diagnosis should include hemangiomas and metastases. CT and MRI can be helpful especially in excluding hemangiomas and metastases, but in some cases a liver biopsy is indicated

More examples of fatty changes, hemangiomas and hyperechoic metastases in the liver can be found in

Copyright © Dr. T.S.A. Geertsma, Ziekenhuis Gelderse Vallei, Ede, The Netherlands. All rights reserved.

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