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For a lesion diameter below 10 mm US accuracy is greatly reduced, reaching approx. 20%. Other elements contributing to lower US performance are: excessive obesity, fatty liver disease, hypomobility of the diaphragm, and certain patterns of hyperechoic or isoechoic metastases that can be overlooked or can mimic benign conditions.
Tissues that have higher echogenicity are called "hyperechoic" and are usually represented with lighter colors on images in medical ultrasonography. In contrast, tissues with lower echogenicity are called "hypoechoic" and are usually represented with darker colors.
At ultrasound, lipoma is a well–defined, homogeneous, hyperechoic paratesticular lesion of varying size [Fig. 14]. The simple finding of an echogenic fatty mass within the inguinal canal, while suggestive of a lipoma, should also raise a question of fat from the omentum secondary to an inguinal hernia.
Angiomyolipoma seen as a hyperechoic mass in the upper pole of an adult kidney on renal ultrasonography. Renal ultrasonography of a person with tuberous sclerosis and multiple angiomyolipomas in the kidney: Measurement of kidney length on the US image is illustrated by '+' and a dashed line. CT scan of a renal angiomyolipoma.
A cavernous liver hemangioma or hepatic hemangioma is a benign tumor of the liver composed of large vascular spaces lined by monolayer hepatic endothelial cells. It is the most common benign liver tumour, and is usually asymptomatic and diagnosed incidentally on radiological imaging or during laparotomy for other intra-abdominal issues.
Features of benign lesion are: hyperechoic, having coarse, dysmorphic or curvilinear calcifications, comet tail artifact (reflection of a highly calcified object), absence of blood flow in the nodule, and presence of cystic (fluid-filled) nodule. However, the presence of solitary or multiple nodules is not a good predictor of malignancy.
The kidney is surrounded by a capsule separating the kidney from the echogenic perirenal fat, which is seen as a thin linear structure. [1] The kidney is divided into parenchyma and renal sinus. The renal sinus is hyperechoic and is composed of calyces, the renal pelvis, fat and the major intrarenal vessels.
Preoperative diagnostics for angiolipoma usually involve computed tomography (CT) with a hyperechoic mass and magnetic resonance imaging (MRI). [9] Nevertheless, these techniques are not very good at giving a conclusive diagnosis for these malignancies.