Ultrasound images Simple cysts

Typical simple liver cyst demonstrating a
band of posterior enhancement. A smaller, bilocular cyst

is seen behind it.

One of the most frequently seen liver lesions, the simple cyst, is either congenital (from abnormal development of a biliary radicle) or acquired (from trauma or previous infection). It is asymptomatic, unless large enough to cause a ‘mass effect’, compressing and displacing adjacent structures, and is 

usually an incidental finding during the ultrasound scan. Frequently, small cysts are peripheral and therefore more likely to be missed on ultrasound than CT.

The ultrasound images simple cyst has three acoustic properties, which are pathognomonic (see Table below); it is anechoic, has a well-defined smooth capsule and exhibits posterior enhancement increased throughtransmission of sound) (Fig. above). Although theoretically it is possible to confuse a simple cyst with a choledochal cyst the latter’s connection to the biliary tree is usually emonstrable on ultrasound. A radioisotope hepatic iminodiacetic acid (HIDA) scan will confirm the biliary connection if doubt exists.

(Table ) Cystic focal liver lesions—differential diagnoses

Simple cyst Anechoic, thin capsule, Common finding, usually posterior enhancement insignificant. Consider (may contain thin septa) polycystic disease if multiple (Rarely an AV malformation may mimic a septated cyst—exclude by using colour Doppler).

Complex cyst

Thin capsule + internalechoes :  Haemorrhage or infection in a cyst Mucinous metastasis Cystadenoma.
Capsule thickened or Hydatid cyst complex, : may also Cystadenocarcinoma contain echoes Intrahepatic pancreatic pseudocyst (rare).
Solid/cystic lesion Irregular margin, internal Abscess echoes + debris/solid Haematoma material: Necrotic metastasis Cavernous haemangioma.

LiveJournal Tags: ultrasound images of Cavernous haemangioma,ultrasound images of Cystic focal liver lesions,ultrasound images differential diagnoses.diagnoses,Ultrasound images Simple cysts.

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