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Radiology General 6c7d8ada

A 22 year old man presents with a solitary 2 cm space occupying lesion of mixed echogenicity in the right lobe of liver on ultrasound examination. The rest of the liver is normal. Which of the following tests should be done next:

A
Ultrasound guided biopsy of the lesion
B
Hepatic Scintigraphy
C
Hepatic angiography
D
Contrast enhanced CT scan of the liver
High-Yield Explanation
B i.e. Hepatic scintigrahy MC benign liver tumor in young adult is cavernous HemangiomaQ which is typically < 3cm, well defined, at posterio-superior segment of (Rt.) lobe of liver. It is homogenous - hyperchoic in 80% and mixed density in rest. Cavrnous Hemangioma suspected on U/S examination; dx confirmed by. Lesions < 2.5 cm in diameter 2.5 cm MRI +- Gadolinium Tc 99m RBC SPECT MRI has added advantage of being more specific than SPECT (or Hepatic scintigraphy or RBC scintigraphy) in diagnosing other hepatic lesions. Dynamic CECT is less specific than MRI and scintigraphy. Therefore, in this context, best answer is MRI followed by hepatic scintigraphy f/b Dynamic contrast in enhanced CT ScanQ.

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