Cystic hepatobiliary lesions: differentiation with cross sectional imaging

Abstract

The purpose of this article is to review the imaging findings of cystic hepatobiliary lesions in the adult in order to identify any features that will help the radiologist understand and recognise the underlying disease. Cystic hepatobiliary lesions in the adult can be classified as developmental, neoplastic, inflammatory, infectious and miscellaneous. Congenital cystic liver lesions are in general simple cysts, including benign developmental hepatic cysts, hamartomas (von Meyenberg complex), Caroli disease and adult polycystic liver disease. Neoplastic cystic lesions include biliary cystadenoma-cystadenocarcinoma, cystic metastases and cystic subtypes of primary liver neoplasms or other liver lesions (such as cystic haemangioma). Inflammatory or infectious hepatic cystic lesions include abscess (pyogenic, amoebic or fungal) and echinococcal cysts. Miscellaneous cystic liver lesions include post-traumatic haematoma, biloma, infected or haemorrhagic hepatic cysts and intrahepatic pseudocyst. In this article, specific imaging features on computed tomography and magnetic resonance imaging of hepatobiliary cystic lesions, such as presence and thickness of a cystic wall or septations, calcifications or nodularity, enhancement (in and around the lesion), will be displayed in order to help the radiologist to approach the correct diagnosis.