Hyperechoic liver lesions

A hyperechoic liver lesion on ultrasound can arise from a number of entities, both benign and malignant. A benign hepatic haemangioma is the most common entity encountered, but in patients with atypical findings or a risk for malignancy, other entities must be considered.


The presence of hyperechogencity can be a result of fat within a liver lesion, 2 although some non-fat-containing lesions may also be echogenic (e.g. hepatic haemangiona) .


Some suggest pulse inversion harmonic imaging with quantitative evaluation as being a useful in facilitating the differential diagnosis of hyperechoic focal liver lesions, where a lesion-liver ratio equal to or greater than 1 being predictive of a benign nature, assuming that malignant lesions show a ratio of less than 1 1.

If a single, well-defined, homogeneous, echogenic mass < 3 cm is found in an asymptomatic patient, without a history of malignancy and without risk factors for liver tumours, then a diagnosis of haemangioma can be made on ultrasound without the need for another test. 5 If an appropriate clinical history is not available, then a wider differential is appropriate.

Ultrasound - general index
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Article information

rID: 17147
Section: Approach
Synonyms or Alternate Spellings:
  • Hyperechoic liver lesion
  • Hyper-echoic liver lesions
  • Echogenic liver lesions
  • Echogenic liver lesion
  • Echogenic liver lesions on ultrasound
  • Hyperechoic liver lesions on ultrasound
  • Liver lesions bright on ultrasound
  • Liver lesions that are bright on ultrasound

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Cases and figures

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    Case 1: hepatic haemangioma
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    Case 2: focal hepatic steatosis
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    Case 3: hepatic adenoma
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