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Ultrasound
Diagnosis
Liver
Focal Solid Masses
CEUS Liver: Pseudolesions
CEUS Liver: Pseudolesions
Zeno Spârchez, MD, PhD; Andrej Lyshchik, MD, PhD
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KEY FACTS

  • Terminology

    • US Findings

      • CEUS Findings

        TERMINOLOGY

        • Abbreviations

          • Inflammatory pseudotumor (IPT)
          • Arterioportal shunt (APS)

        • Definitions

          • Pseudolesions are focal areas of abnormal, mass-like enhancement commonly seen on CT and MR without underlying parenchymal changes
            • Appear due to unusual hemodynamics, vascular compromise, and arterioportal shunting
            • Vascular pseusolesions commonly develop in patients with cirrhosis and may or may not be associated with tumors, such as hepatocellular carcinoma (HCC)
            • Hyperenhancing pseudolesions mimic HCCs in cirrhotic liver, especially if round or oval
          • Pseudotumors are focal, mass-like, nonneoplastic parenchymal changes, such as focal fatty deposition, focal fatty sparing, and IPT

        IMAGING

        • US Findings

          • CEUS Findings

            Selected References

            1. Elsayes KM et al: Spectrum of pitfalls, pseudolesions, and misdiagnoses in noncirrhotic liver. AJR Am J Roentgenol. 211(1):97-108, 2018
            2. Kong WT et al: The analysis of enhancement pattern of hepatic inflammatory pseudotumor on contrast-enhanced ultrasound. Abdom Imaging. 39(1):168-74, 2014
            3. Kobayashi S et al: Radiologic manifestation of hepatic pseudolesions and pseudotumors in the third infow area. Imaging Med. 2(5): 519–528, 2010
            4. Hirche TO et al: Evaluation of hepatic steatosis by ultrasound in patients with chronic hepatitis C virus infection. Liver Int. 27(6):748-757, 2007
            5. Catalano O et al: Transient hepatic echogenicity difference on contrast-enhanced ultrasonography: sonographic sign and pitfall. J Ultrasound Med. 26(3):337-45, 2007
            6. Schneider G et al: Hepatic pseudolesions. In Schneider G et al: Hepatic pseudolesions. MRI of the Liver: Imaging Techniques, Contrast Enhancement, Differential Diagnosis. Milan: Springer-Vertag. 151-186, 2006
            Related Anatomy
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            References
            Tables

            Tables

            KEY FACTS

            • Terminology

              • US Findings

                • CEUS Findings

                  TERMINOLOGY

                  • Abbreviations

                    • Inflammatory pseudotumor (IPT)
                    • Arterioportal shunt (APS)

                  • Definitions

                    • Pseudolesions are focal areas of abnormal, mass-like enhancement commonly seen on CT and MR without underlying parenchymal changes
                      • Appear due to unusual hemodynamics, vascular compromise, and arterioportal shunting
                      • Vascular pseusolesions commonly develop in patients with cirrhosis and may or may not be associated with tumors, such as hepatocellular carcinoma (HCC)
                      • Hyperenhancing pseudolesions mimic HCCs in cirrhotic liver, especially if round or oval
                    • Pseudotumors are focal, mass-like, nonneoplastic parenchymal changes, such as focal fatty deposition, focal fatty sparing, and IPT

                  IMAGING

                  • US Findings

                    • CEUS Findings

                      Selected References

                      1. Elsayes KM et al: Spectrum of pitfalls, pseudolesions, and misdiagnoses in noncirrhotic liver. AJR Am J Roentgenol. 211(1):97-108, 2018
                      2. Kong WT et al: The analysis of enhancement pattern of hepatic inflammatory pseudotumor on contrast-enhanced ultrasound. Abdom Imaging. 39(1):168-74, 2014
                      3. Kobayashi S et al: Radiologic manifestation of hepatic pseudolesions and pseudotumors in the third infow area. Imaging Med. 2(5): 519–528, 2010
                      4. Hirche TO et al: Evaluation of hepatic steatosis by ultrasound in patients with chronic hepatitis C virus infection. Liver Int. 27(6):748-757, 2007
                      5. Catalano O et al: Transient hepatic echogenicity difference on contrast-enhanced ultrasonography: sonographic sign and pitfall. J Ultrasound Med. 26(3):337-45, 2007
                      6. Schneider G et al: Hepatic pseudolesions. In Schneider G et al: Hepatic pseudolesions. MRI of the Liver: Imaging Techniques, Contrast Enhancement, Differential Diagnosis. Milan: Springer-Vertag. 151-186, 2006