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For a lesion diameter below 10 mm US accuracy is greatly reduced, reaching approx. 20%. Other elements contributing to lower US performance are: excessive obesity, fatty liver disease, hypomobility of the diaphragm, and certain patterns of hyperechoic or isoechoic metastases that can be overlooked or can mimic benign conditions.
At ultrasound, lipoma is a well–defined, homogeneous, hyperechoic paratesticular lesion of varying size [Fig. 14]. The simple finding of an echogenic fatty mass within the inguinal canal, while suggestive of a lipoma, should also raise a question of fat from the omentum secondary to an inguinal hernia.
Currently, if the hepatic adenoma is >5 cm, increasing in size, symptomatic lesions, has molecular markers associated with HCC transformation, rising level of liver tumor markers such as alpha fetoprotein, the patient is a male, or has a glycogen storage disorder, the adenoma is recommended to be surgically removed. [7]
Tissues that have higher echogenicity are called "hyperechoic" and are usually represented with lighter colors on images in medical ultrasonography. In contrast, tissues with lower echogenicity are called "hypoechoic" and are usually represented with darker colors.
A cavernous liver hemangioma or hepatic hemangioma is a benign tumor of the liver composed of large vascular spaces lined by monolayer hepatic endothelial cells. It is the most common benign liver tumour, and is usually asymptomatic and diagnosed incidentally on radiological imaging or during laparotomy for other intra-abdominal issues.
On ultrasound, cavernous haemangiomas in liver appeared as homogenous, hyperechoic lesions with posterior acoustic enhancement. On CT or MRI scans, it shows peripheral globular/nodular enhancement in the arterial phase, with portions of attenuation of enhancing areas.
Features of benign lesion are: hyperechoic, having coarse, dysmorphic or curvilinear calcifications, comet tail artifact (reflection of a highly calcified object), absence of blood flow in the nodule, and presence of cystic (fluid-filled) nodule. However, the presence of solitary or multiple nodules is not a good predictor of malignancy.
A sclerotic lipoma is a predominantly fibrous lesion with ... In this case a heterogeneous mass consisting of an upper hyperechoic ... A homogeneous hypoechoic mass ...