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BENIGN FOCAL LIVER LESIONS;Clinical features of an abscess(脓肿);Ultrasound appearances;(A) Early stages of a pyogenic abscess in a transplanted liver. The lesion looks quite solid, but note the posterior enhancement.;The margins of an abscess are irregular and often ill-defined and frequently thickened. The inflammatory capsule of the abscess may demonstrate vascularity(多血管) on colour or power Doppler but this is not invariable and depends on equipment sensitivity and size of the lesion.;There are three main types of abscess;Pyogenic abscess;Amoebic abscess;Candidiasis abscess;Management of hepatic abscesses;;Haematoma;The acoustic appearances depend upon the timing—a fresh haematoma may appear liquid and echo-poor, but rapidly becomes more ‘solid’-looking and hyperechoic, as the blood clots(凝结). As it resolves the haematoma liquefies and may contain fibrin strands. It will invariably demonstrate a band of posterior enhancement and has irregular, illdefined walls in the early stages. Later on it may
encapsulate, leaving a permanent cystic ‘space’ in the liver, and the capsule may calcify.;Intrahepatic haematoma following a road traffic accident with rib fractures. The lesion is relatively fresh and contains some low-level echoes.;2-day-old subcapsular haematoma. The collection
became progressively smaller and hyperechoic as it
resolved.;Intervention is rarely necessary and monitoring with ultrasound confirms eventual resolution. More serious hepatic ruptures, however, causing
Haemoperitoneum(腹腔积血), usually require surgery.;Thank you!
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