LESION OF LIVER HOW TO PREPARE

1. COMMON LIVER LESIONS

2. HEMANGIOMA
• ULTRASOUND
• Typically well-defined hyperechoic lesions
• Color Doppler: may show peripheral feeding vessels
• MRI
• Typical features include:
• T1: hypointense relative to liver parenchyma
• T2: hyperintense relative to liver parenchyma, but less
than the intensity of CSF or of a hepatic cyst
• DWI: hyperintense on diffusion-weighted imaging

3. HEMANGIOMA
• CT
• non-contrast: Often homogeneous hypoattenuating
(<20 Hounsfield units) relative to liver parenchyma 23
• late arterial phase: typically show discontinuous,
nodular, peripheral enhancement (small lesions may
show uniform enhancement)
• portal venous phase: progressive peripheral
enhancement with more centripetal fill-in
• delayed phase: further irregular fill-in and therefore iso-
or hyper-attenuating to liver parenchyma
• Other described features include:

6. Hepatic Adenoma
• Ultrasound
• A hepatic adenoma usually presents as a solitary, well-demarcated, heterogeneous mass.
Echogenicity is variable
• color Doppler: may show perilesional sinusoids
• contrast-enhanced ultrasound 16:
• CT
• fresh hemorrhage: may be hyperattenuating
• fat content: may render the mass hypoattenuating
• In general, they are well-marginated and isoattenuating to the liver..
• Calcification may be seen in areas of old hemorrhage (5-10% of cases 10).
• MRI
• In non-hemorrhagic adenomas, they typically appear as:
• T1: variable and can range from being hyper-, iso-, to hypointense (hyperintense in 35-77% of
cases 8)
• T2: mildly hyperintense (in 47-74% of cases 2,8)
• IP/OP: the presence of fat typically leads to signal drop out on out-of-phase imaging
• T1 C+ (Gd)
• some reports suggest that the enhancement becomes isointense to the rest of the liver by 1