ARRS 2022 Abstracts

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E1932. The Good: Imaging Appearance of Benign Masses in the Liver
Authors
  1. Michelle Lam; Santa Clara Valley Medical Center
  2. Vishesh Jain; Santa Clara Valley Medical Center
  3. Luyao Shen; Stanford University Medical Center
  4. Edwina Chang; Santa Clara Valley Medical Center; Stanford University Medical Center
Background
Hepatic masses, benign and malignant, may have a myriad of appearances on ultrasound, CT, and MRI. Hepatic masses, commonly found incidentally on imaging, may oftentimes be benign in etiology based on imaging features on subsequent dedicated ultrasound, CT, and MRI protocols. Understanding the typical and atypical images of benign and malignant hepatic masses on multimodality imaging will enable the novice and experienced radiologist to make a clinically appropriate differential diagnosis in the indeterminate hepatic mass based on imaging features and clinical history. This educational exhibit will review the uncommon imaging appearance of common benign hepatic masses, as well as the common imaging appearance of uncommon benign hepatic masses, using key pearls and pitfalls that will aid in diagnosis.

Educational Goals / Teaching Points
The goals of this exhibit are to review the US, CT, and MRI protocol for diagnosing hepatic masses; learn the uncommon imaging appearance of benign hepatic masses; learn the common imaging appearance of uncommon benign hepatic masses; analyze the imaging characteristics of the indeterminate hepatic mass by its content (blood, fat, enhancement characteristic, growth, fluid); and understand the pearls and pitfalls in putting together a clinically appropriate differential diagnosis.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Key topics of the exhibit include: US, CT, and MRI protocol for diagnosing hepatic masses; cysts; hemangiomas (including atypical imaging appearance of sclerosing hemangiomas); adenoma and its subtypes; focal nodular hyperplasia; regenerative nodule/dysplastic nodule (and differentiating from hepatocellular carcinomas); biliary hamartomas; biliary cystadenomas (and differentiating from cystadenocarcinomas); focal fat; angiomyolipoma; lipoma; and iatrogenic pseudotumor.

Conclusion
Hepatic masses, benign and malignant, may have a myriad of appearances on ultrasound, CT, and MRI. Benign hepatic masses are commonly incidental but may often require subsequent dedicated protocols for definitive diagnosis. Understanding the typical and atypical images of benign and malignant hepatic masses on multimodality imaging will enable the novice and experienced radiologist to make a clinically appropriate differential diagnosis based on imaging features and clinical history. This educational exhibit reviews the uncommon imaging appearance of common benign hepatic masses, as well as the common imaging appearance of uncommon benign hepatic masses, using key pearls and pitfalls that will aid in diagnosis.