Regenerating nodules in cirrhosis: Sonographic-pathologic correlation

To define sonographic appearances of regenerating nodules in cirrhosis, we undertook a sonographic-pathologic correlation study. Sonograms of five resected noncirrhotic livers and ten resected cirrhotic liver specimens were obtained by using 2-4 MHz and 5-10 MHz broadband transducers. The presence of focal lesions in the sonograms were investigated by two radiologists without pathologic information and correlated with pathological specimens. By using 5-10 MHz transducers, majority of regenerating nodules were depicted as ill-defined or well-defined hypoechoic focal lesions surrounded by complete or incomplete hyperechoic fibrous rim. By using 2-4 MHz transducers, regenerating nodules larger than 6 mm were depicted as hypoechoic focal lesions whereas nodules smaller than 5 mm were not depicted clearly but produce inhomogeneous, increased echogenicity and coarsening of the parenchymal echotexture depending on the amount of fibrous septae surrounding regenerating nodules. It is concluded that, in routine abdominal sonography by using 2-4 MHz transducers, regenerating nodules larger than 6 mm can be depicted but nodules less than 5 mm produce increased and coarse hepatic echotexture.