Liver Imaging

Liver lesions have a broad spectrum of pathologies ranging from benign liver lesions such as hemangiomas to malignant lesions such as primary hepatocellular carcinoma and metastasis. Imaging is a crucial step in diagnosing these conditions as liver enzymes can elevate in 8% of people in the U.S. A combination of medical history, serologic, and radiologic investigations can provide the diagnosis in most of these cases. Liver lesions can be categorized into focal and diffuse liver lesions. Focal liver lesions can subclassify into three main clinical categories. Diffuse liver lesions can categorize into vascular, inflammatory diseases, and storage disease. Benign liver lesions can be classified into 3 categories based on their origination: Cholangiocellar: hepatic cyst, biliary cystadenoma, intraductal papillary neoplasm of the bile ducts, peribiliary cyst, intrahepatic bile adenoma, Hepatocellular: focal nodular hyperplasia, hepatic adenoma Mesenchymal: hemangioma, lipoma Liver ultrasonography (US), computed tomography (CT), magnetic resonance imaging (MRI) are the primary imaging modalities to diagnose liver lesions. Post intravenous (IV) contrast imaging has unique features in the liver because the liver has three distinct phases, which are the arterial phase, the portal venous phase, and the venous phase. The US can be a method of choice as a screening modality, and contrast-enhanced multidetector CT (MDCT) as a modality of choice in most hepatic imaging.