Fig. 7
From: Role of shear wave sono-elastography (SWE) in characterization of hepatic focal lesions
(example of left lobe focal lesion): 55 years old male patient with chronic liver disease under follow up abdominal ultrasound. Imaging findings: grey scale B-mode ultrasonography (a): shrunken cirrhotic liver with a well-defined hyperechoic focal lesion seen in left lobe measuring 4.5 × 4.1 cm with 3.6 cm depth from the skin. ϖ Color-coded shear wave sono-elastography: the lesion (b, c, d) and parenchyma (e, f, g) showed variable colors in the three acquisitions. ϖ Shear wave sono-elastography stiffness values of the focal lesion: the lesion showed variable stiffness values in the three acquisitions. E1 = 18.59 kPa (b), E2 = 8.67 kPa (c), and E3 = 12.18 kPa (d). Calculated average stiffness value of the three acquisitions = 13.14 kPa. ϖ Shear wave sono-elastography stiffness values of the parenchyma: the parenchyma showed variable stiffness values in the three acquisitions. E1 = 15.86 kPa (e), E2 = 11.13 kPa (f), and E3 = 19.27 kPa (g). Calculated average stiffness value of the three acquisitions = 15.42 kPa. • Lesion/parenchyma stiffness ratio = 0.89. ϖ Axial contrast enhanced triphasic CT study (arterial (h), portal (i), delayed (j)): shrunken cirrhotic liver with a well-defined focal lesion seen in left lobe showed enhancement in the arterial and portal phases with washout in delayed phase. ϖ Diagnosis: left lobe HCC