Learning objectives
- To review the pathogenesis and imaging spectrum of hepatic cystic lesions.
- To provide a practical diagnostic algorithm that facilitates differential diagnosis.
Background
Hepatic cystic lesions – defined as lesions with predominant near-water content – are commonly encountered in everyday practice.
The differential diagnosis ranges from benign developmental to malignant lesions,
whose prognosis and management is radically different.
An important first step for narrowing the differential diagnosis is to determine the presence or absence of complex features in cystic liver lesions.
Simple hepatic cystic lesions
Simple cysts
are one of the commonest liver lesions andoccur in in 2,5 % of the population.
They are usually asymptomatic and more...
Findings and procedure details
Simple hepatic cystic lesions
appear as round or ovoid fluid-containing lesions with smooth imperceptible well-defined walls and no evidence of complex internal features,
such as septations,
mural irregularity,
nodularity or wall calcification.
No enhancement is seen after intravenous contrast media administration (Fig3).
Imaging features
On ultrasound,
a hepatic cyst appears as a well-circumscribed anechoic lesion with posterior acoustic enhancement.
On CT: homogeneous hypoattenuation (water attenuation around 0-10 HU).
In fatty livers simple cyst can appear iso- or hyperattenuating compared to hepatic parenchyma on precontrast images....
Conclusion
A practical diagnostic algorithm based on key imaging features and patient history may guide the radiologist in making the diagnosis or a reasonable differential diagnosis of hepatic cystic lesions.
References
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Cystic Hepatic Lesions: A Review and an Algorithmic Approach.
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10.2214/AJR.13.12386
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Congenital diseases of intrahepatic bile ducts: variations on the theme “ductal plate malformation.” Hepatology 1992; 16:1069–1083.
3. Behroze Vachha,
Maryellen R.
M.
Sun,
Bettina Siewert and Ronald L.
Eisenberg (2011) Cystic Lesions of the Liver.
Am J Roentgenol.
196(4):W355-66
4. Mortele KJ,
Ros PR.
Cystic focal liver lesions in the adult: differential CT and MR imaging features.
RadioGraphics 2001; 21:895–910...