Journal of Clinical and Translational Hepatology

Journal of Clinical and Translational Hepatology

Monday, 12 / 10 / 2018

Differentiating Cystic Liver Lesions: A Review of Imaging Modalities, Diagnosis and Management

REVIEW ARTICLE

Differentiating Cystic Liver Lesions: A Review of Imaging Modalities, Diagnosis and Management

Marianna G. Mavilia*,1, Tina Pakala2, Marco Molina3 and George Y. Wu1

1Department of Medicine, Division of Gastroenterology-Hepatology, University of Connecticut Health Center, Farmington, CT, USA
2Department of Medicine, Division of Gastroenterology-Hepatology, New York Presbyterian Hospital, New York, NY, USA
3Department of Radiology, University of Connecticut Health Center, Farmington, CT, USA

*Correspondence to: Marianna G. Mavilia, Department of Medicine, University of Connecticut Health Center, 263 Farmington Ave, Farmington, CT 06032, USA. Tel: +1-860-679-2509, Fax: +1-860-679-6582, E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

Journal of Clinical and Translational Hepatology 2018;6(2):208-216 DOI: 10.14218/JCTH.2017.00069
Received: October 20, 2017 Accepted: November 20, 2017 Published online: January 5, 2018

Abstract

Hepatic cysts (HCs) are frequently discovered incidentally on abdominal imaging. The prevalence of HCs has been reported as high as 15–18% in the United States. Although most cysts are benign, some are malignant or premalignant. It is important to diagnose cystic lesions in order to properly manage them. Imaging with conventional ultrasound, computed tomography, magnetic resonance imaging, or contrast-enhanced ultrasound can be used to further characterize and diagnose HCs. Ultrasound is typically the first-line imaging modality, whereas more advanced imaging can help narrow down the specific lesion. Contrast-enhanced ultrasound is a newer modality, recently approved in the United States, which offers non-invasive evaluation in real-time. The first step in diagnosis is stratifying risk by differentiating simple and complex cysts. There are several features that can help identify HCs, including septae, mural consistency, calcifications, and quality of cystic fluid. Simple cysts are mainly congenital cysts, but also occur in polycystic liver disease. Complex cysts include mucinous neoplasms, echinococcal cysts, hemorrhagic cysts, cystic hepatocellular carcinoma and other rare lesions. Treatment is indicated in symptomatic cysts or those suspicious for malignant or premalignant features. Treatment modalities include fenestration, aspiration sclerotherapy, or surgical resection.

Keywords

Hepatic cyst, Simple cyst, Complex cyst, Hepatic imaging, Contrast-enhanced ultrasound, Treatment

 

 

Journal of Clinical and Translational Hepatology 2018 vol. 6, 208-216  [ Html ] [ PDF Full-text ]

© The Authors 2018. This article is published under the terms of the Creative Commons Attribution-Noncommercial License (CC BY-NC 4.0), which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license.

 

 logo

You are here: Home Archive Vol 6 Issue 2 Differentiating Cystic Liver Lesions: A Review of Imaging Modalities, Diagnosis and Management