US Quiz of the Month – November 2016


We present the case of a 26-year-old who was referred to our centre due to the discovery of a focal liver lesion in an ambulatory ultrasonography. We repeated the abdominal ultrasonography, identifying an isoechoic nodule with approximately 30 mm of bigger axis located in segment V.

Figure 1. Hepatic isoechoic nodule in segment V.


With the use of Doppler and 3-dimensional (3D) software, we were able to determine the existence of a central scar and radial distribution of the nodule vascularization. These findings taken together are characteristic of focal nodular hyperplasia (FNH).



Figure 2. A) Doppler mode; B) three dimensional reconstruction of the nodule vascularization, depicting the typical characteristics of focal nodular hyperplasia.



3D ultrasonography represents a development in the ultrasonography field, with the advantage of creating ultrasound sections impossible to see on a routine scan. Additionally, it allows accurate volume measurements and interactive manipulation of volume data . In this case, the use of 3D ultrasonography associated with Doppler study allowed the clear demonstration of the typical characteristics of FNH, avoiding the need of more expensive exams.




1. Kupesic S, Kurjak A. Clinical Application of 3D Sonography: Taylor & Francis; 2000



Paula Sousa1, Tiago Capela2, Ana Caldeira3, Eduardo Pereira3, António Banhudo3

1. Gastroenterology Department, Centro Hospitalar Tondela-Viseu

2. Gastroenterology Department, Centro Hospitalar Lisboa Central

3. Gastroenterology Department, Hospital Amato Lusitano