Fig. 4
From: Role of shear wave sono-elastography (SWE) in characterization of hepatic focal lesions
Fifty-six years old male patient with chronic liver disease for follow-up abdominal ultrasound. Imaging findings: grey scale B-mode ultrasonography (a): normal sized cirrhotic liver with a well-defined hyperechoic focal lesion seen in segment VI measuring 5.4 × 5.5 cm with 3.8 cm depth from the skin. ϖ Color-coded shear wave sono-elastography: the lesion (b, c, d) and the parenchyma (e, f, g) showed mixed color with red foci. ϖ Shear wave sono-elastography stiffness values of the focal lesion: E1 = 17.42 kPa (b), E2 = 17.35 kPa (c), and E3 = 16.57 kPa (d). Calculated average stiffness value of the lesion = 17.11 kPa. ϖ Shear wave sono-elastography stiffness values of the parenchyma: E1 = 16.12 kPa (e), E2 = 16.41 kPa (f), and E3 = 16.53 kPa (g). Calculated average stiffness value of the parenchyma = 16.35 kPa. • Lesion/parenchyma stiffness ratio = 1.04. ϖ Axial contrast enhanced triphasic CT study (arterial (h), portal (i), delayed (j)): average size cirrhotic liver with a well-defined focal lesion seen in segment VI showing enhancement in the arterial phase and washout in portal and delayed phases. ϖ Diagnosis: hepatocellular carcinoma