Objectives

- To describe a variety of cystic hepatic lesions and their imaging features using multimodality imaging (CT and MRI) through a case based review

- To provide a systematic approach for the differential diagnosis of cystic hepatic lesions

Background

Cystic hepatic lesions represent a frequent hepatic pathology, including a wide spectrum of entities with different etiologies. They are divided into congenital/developmental (simple hepatic cyst, hamartomas, Caroli disease, polycystic liver disease), inflammatory/infectious (pyogenic, amebal, fungal abscess and hydatic cyst), neoplastic (biliary cystadenoma/ cystadenocarcinoma, cystic HCC and cystic metastases), trauma/iatrogenic-related (hematoma and biloma).

Imaging findings OR Procedure findings

This poster highlights key CT and MR imaging aspects of cystic hepatic lesions, providing examples for each entity. The common feature of all these lesions is represented by their fluid content. Differential diagnosis can be made by identifying some pathognomonic features for each entity. When evaluating cystic hepatic lesions, the first step is to assess their number, location and size. Next, the morphology of the cyst should be evaluated in order to classify it as simple or complex. The most important morphological imaging findings are: wall thickness, presence or absence of septa, calcifications, solid components and enhancing patterns. Also, patient's clinical and biological parameters should be considered when establishing the final/most probable diagnosis.

Conclusion

Because of the wide etiology of cystic hepatic lesions, radiologists should be aware of the causes and specific imaging features of these entities in order to provide an accurate diagnosis useful for proper management of the patient.