Ultrasound Cases Logo
Search Cases

Case of the Month

December 2010

Patient Data: 44 year old female

Clinical Info: Incidentally found abnormal liver


36415-Afbeelding1.jpg
Transverse image of the liver. The liver has multiple small hyperechoic lesions


36416-Afbeelding2.jpg
Another image of the same liver with multiple hyperechoic lesions


36417-Afbeelding3.jpg
Another image of the same liver


36418-Afbeelding4.jpg
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


36424-Afbeelding5.jpg
The following images also show incidentally found hyperechoic lesions in a 47 year old female


36425-Afbeelding6.jpg
High frequency image of another lesion in the same liver


36426-Afbeelding7.jpg
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.

Developed by Prominent Media Web Development