Liver

SOLITARY LIVER MASS

Hepatocellular carcinoma—Cirrhosis Adenoma—Woman on oral contraceptive Focal nodular hyperplasia—Central scar Cholangiocarcinoma—accompanying biliary ductal dilatation Pyogenic abscess—Complex cystic Focal sparing of fatty liver—Gallbladder fossa, portal bifurcation

Focal Liver Hyperechogenicity

HYPERECHOIC LIVER LESIONS

Hemangioma—MRI for confirmation Focal fat—next to falciform ligament in anterior aspect of segment 4, portal bifurcation Metastases—Mucinous such as colon or ovarian

Any other primary liver tumor

MULTIPLE CALCIFIED HEPATIC MASSES

Stones

Histoplasmosis PCP

COMPLEX CYSTIC MASS

Infection

Abscess—pyogenic or amebic

Echinococcus

Tumor

Cystic metastases—ovarian Biliary cystadenoma

Hemmorhagic mass—e.g., adenoma (solitary)

Necrotic metastases—sarcoma

Trauma

Hematoma (solitary) Biloma (solitary)

Edematous Gallbladder Hyperplasia

MULTIPLE SIMPLE CYSTS

Cysts Caroli's

DIFFUSE INHOMOGENEOUS LIVER ECHOTEXTURE

Cirrhosis—ascites, surface nodularity Metastases

Fatty infiltration—loss of portal triad hyperechogenicity Lymphoma

Kaposi in immunocompromised

Emphysematous Hepatitis

GALLBLADDER SMALL INTRALUMINAL GALLBLADDER LESIONS

Stones—shadow, mobile

Emphysematous Hepatitis

Cholesterol polyps—No shadow, not mobile

Cholesterol crystals—ring-down, not dependent

GALLBLADDER MASSES

Polyp—<1 cm Tumefactive sludge—mobile Focal adenomyomatosis Chronic cholecystitis Gallbladder carcinoma Metastases—melanoma

Sludge Gallbladder

GALLBLADDER WALL THICKENING (MANY CAUSES)

Biliary—cholecystitis, adenomyomatosis, AIDS cholangitis

Edema—hypoproteinemia (cirrhosis, nephrotic syndrome), congestive heart failure Hepatitis

Monster Fatberg Devon

SHADOWING IN THE GALLBLADDER FOSSA

WES of stones

Porcelain gallbladder—must be removed because of increase risk of carcinoma Emphysematous cholecystitis

Neck Granuloma Ultrasound

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