Fig. 5

Forty-four years old female patient with intestinal GIST seeking for metastatic work up. Imaging Findings: grey scale B-mode ultrasonography (a): normal sized liver with a well-defined hypoechoic focal lesion seen in segment VI measuring 9 × 5.9 cm with 2.6 cm depth from the skin. ϖ Color-coded shear wave sono-elastography: the lesion showed mixed color with red foci (b, c, d), while the liver parenchyma showed dark blue color (e, f, g). ϖ Shear wave sono-elastography stiffness values of the focal lesion: E1 = 22.36 kPa (b), E2 = 22.59 kPa (c), and E3 = 23.12 kPa (d). Calculated average stiffness value of the lesion = 22.69 kPa. ϖ Shear wave sono-elastography stiffness values of the parenchyma: E1 = 5.54 kPa (e), E2 = 5.60 kPa (f), and E3 = 5.43 kPa (g). Calculated average stiffness value of the parenchyma = 5.52 kPa. • Lesion/parenchyma stiffness ratio = 4.11. ϖ Axial contrast enhanced triphasic CT study (arterial (h), portal (i), delayed (j) phases): normal size liver with a well-defined focal lesion seen in segment VI showed faint enhancement with central necrotic area. ϖ Pathology: metastasis from GIST. ϖ Diagnosis: metastasis from GIST