中年女性,健檢意外發現
well-defined echogenic tumor
分析:hemangioma, focal fatty infiltration, HCC, metastasis, FNH, hepatic adenoma
- Hemangioma: 僅次於cyst,常見良性肝病灶,尤其在女生,通常沒有症狀。典型影像為echogenic tumor (如本案例),另外"reverse target sign" 也很常見。如果US發現的話,MRI 或CT 可以確定診斷。
Reverse target sign: hypoechoic center with echogenic rim
- Focal fatty infiltration: 通常病人有obesity, alcoholism 或是glycogen storage disease.通常會呈現geographic echogenic regions, 最常出現在falciform ligament 旁邊,或是gallbladder fossa,或是portal confluence
- HCC: 多為hypoechoic lesion, 通常伴隨有肝疾病(cirrhosis),US特徵有hypervascular lesion with satellite lesions, 有時可見portal vein invasion
- Mets: 多為lung, breast and GI tract(colon) primary cancer
- FNH: 多出現在女性,典型特徵為isoechoic 加上central scar.
- Hepatic adenoma: 台灣少,女性,glycogen storage disease. 多為isoechoic.
答案:hemangioma