DMS 176 – Metastatic Disease in the Liver, Portal Vein Gas, Pneumobilia and Granulomas
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Metastatic disease in the liver is the most common _________
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form of malignancy in the liver
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Metastatic disease in the liver most commonly arises from what organs (in decreasing order)?
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GI tract, breast, colon and lung
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What is the sonographic appearance of liver metastases?
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varies depending on origin of the malignancy
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What is the most common sonographic appearance of metastatic lesions in the liver?
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hypoechoic
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What are some examples of sonographic appearances of liver metastases?
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hypoerechoic or cystic, may contain peripheral halos or calcifications, mixed echogenicity (complex), Target or bull's eye appearance, *Distortion of liver contour*
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What are the lab values associated with liver metastases?
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elevated ALP, AST and ALT and AFP
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What is portal vein gas?
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Air within intrahepatic portal veins
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What is portal vein gas associated with?
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Ulcerative colitis and Crohn's disease
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What is the reason for portal vein gas in infants?
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necrotizing enterocolitis
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What is the sonographic findings of portal vein gas?
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ring down/comet tail artifacts, moving bubbles (echogenic foci) that follow the portal vein path
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What is pneumobilia?
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air in the bile ducts
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What is the cause of pneumobilia?
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instrumentation in bile ducts
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How can pneumobilia be differentiated from portal vein gas?
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air in portal vein can be seen extending to the periphery of the liver while bile duct air does not
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What is granulomas caused by?
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Histoplasmosis or Tuberculosis infection
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What region is granulomas more common in?
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North America in the Great Lakes Basin and mid-west
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What organ are granulomas most commonly seen in?
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spleen
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What is the sonographic findings of granulomas
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small echogenic calcifications in the liver and spleen
