Presentation
Background of diabetes mellitus type II, obesity, and dyslipidemia. Preoperative US - fatty liver? gallbladder?
Patient Data
The liver is enlarged and very echogenic, i.e. markedly fatty.
Several lesions up to 3.7 cm in length are scattered throughout the liver, all of them hypoechoic compared to the liver.
The gallbladder is not dilated, contains anechoic bile and shows thin walls. The common bile duct is not widened.
Case Discussion
All of the larger lesions were shown to be hemangiomas on a multiphase liver CT (unavailable) done several days after the US.
On a background of a fatty liver, hemangiomas, classically hyperechoic to liver parenchyma, can also appear hypoechoic or isoechoic.