Radiology Game: Liver Cysts

Test your knowledge of liver cyst imaging and diagnosis

Welcome to the Radiology Game on Liver Cysts! This quiz will test your knowledge of imaging characteristics, differential diagnosis, and management of liver cysts.

You'll be presented with 5 multiple-choice questions. Select the best answer for each question and see how well you score!

Question 1 of 5

A 45-year-old asymptomatic woman undergoes abdominal ultrasound which shows a 3 cm anechoic lesion in the right lobe of the liver with posterior acoustic enhancement and smooth, thin walls. What is the most likely diagnosis?

A. Simple hepatic cyst

B. Hepatic abscess

C. Cystic metastasis

D. Biliary cystadenoma

Correct Answer: A. Simple hepatic cyst

Simple hepatic cysts typically appear as anechoic lesions with posterior acoustic enhancement and smooth, thin walls on ultrasound. They are usually asymptomatic and incidental findings. Hepatic abscesses typically show internal echoes and debris, cystic metastases often have thick irregular walls, and biliary cystadenomas are multiloculated.

Question 2 of 5

Which of the following imaging findings would be most concerning for a complicated liver cyst rather than a simple cyst?

A. Homogeneous fluid attenuation on CT

B. No internal vascularity on Doppler ultrasound

C. Thick, irregular wall with internal septations

D. Signal intensity following fluid on all MRI sequences

Correct Answer: C. Thick, irregular wall with internal septations

Simple cysts should have thin, smooth walls without septations. Thick, irregular walls and internal septations are concerning features that may indicate a complicated cyst, cystadenoma, cystadenocarcinoma, or cystic metastasis. The other options are characteristic of simple cysts.

Question 3 of 5

A patient with known polycystic kidney disease presents for liver imaging. What is the most common hepatic manifestation of this condition?

A. Hepatic hemangiomas

B. Multiple simple hepatic cysts

C. Focal nodular hyperplasia

D. Hepatocellular carcinoma

Correct Answer: B. Multiple simple hepatic cysts

Polycystic kidney disease is commonly associated with multiple simple hepatic cysts. These cysts are typically asymptomatic but can occasionally become large enough to cause mass effect. Unlike renal cysts in ADPKD, hepatic cysts in this condition rarely cause hepatic dysfunction.

Question 4 of 5

Which MRI characteristic is most specific for a simple hepatic cyst?

A. T1 hyperintensity

B. T2 hypointensity

C. Diffusion restriction

D. Signal suppression on heavily T2-weighted sequences

Correct Answer: D. Signal suppression on heavily T2-weighted sequences

Simple cysts demonstrate fluid signal intensity on all MRI sequences: T1 hypointensity, T2 hyperintensity, no diffusion restriction, and signal suppression on heavily T2-weighted sequences. Signal suppression on heavily T2-weighted sequences is particularly specific for simple fluid-filled cysts.

Question 5 of 5

A 60-year-old patient presents with a complex cystic liver lesion showing internal echoes on ultrasound, peripheral calcifications on CT, and no enhancement on contrast MRI. What is the most likely diagnosis?

A. Hepatocellular carcinoma

B. Hepatic abscess

C. Hydatid cyst

D. Biliary hamartoma

Correct Answer: C. Hydatid cyst

Hydatid cysts (caused by Echinococcus granulosus) often demonstrate internal echoes (daughter cysts), peripheral calcifications, and typically show no enhancement with contrast. The other options do not typically present with this combination of imaging findings.

Quiz Complete!

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