General Ultrasound

Your ultimate resource for General Ultrasound teaching files and General Ultrasound imaging & case of the day. Improve your diagnostic imaging skills online.

Thumbnail image
RUQ US:
35 year old female, vague abdominal pain

Findings?
DDx?
further recommended studies, if any?

Additional Imaging (different patient)

Contrasted CT, 120 s Delay
Same study, 300 s Delay

Thumbnail imageThumbnail image
Final Dx?
Answers
Hepatic Hemangiomas
Thumbnail imageThumbnail imageThumbnail image
Ultrasound shows multiple homogeneous, hyperechoic hepatic masses: DDx hemangioma vs. more malignant process

Dynamic CT scanning (in a different patient) shows a well-circumscribed, hypoattenuating lesion that completely fills-in at 5 min

Answers
Hepatic Hemangioma – MRI Correlation

 

T2-weighted MRI:
Well-defined lesion, brighter than spleen
T1-Gad, at 30 s:
Nodular enhancement at periphery
T1 –Gad, AT 5 MIN:
Most of lesion has enhanced

Thumbnail imageThumbnail imageThumbnail image
Appearance of hemangiomas on US is characteristic but not pathognomonic

DDx includes Hemangioma, Mets, HCC, and nodular fat

Some feel patients at low risk for malignancy require no f/u, but at the least, 6-mo f/u US to evaluate stability is prudent. Nucs / CT /MRI can confirm. Most common benign livertumor, rarely symptomatic, typically no flow by US

Kasabach-Merritt syndrome: liver hemangiomas + platelet sequestration

Biopsy OK if there is normal liver between lesion and liver capsule

These signals are relayed buying clomid online safe which then is by a number of such as medial preoptic and paraventricular nulcei.
javporn.cc