Focal areas of decreased echogenicity in the liver at the porta hepatis.

Twelve patients are described in whom solitary focal hypoechoic areas in the liver were observed adjacent to the gallbladder and portal vein. These areas were all homogeneously hypoechoic relative to adjacent liver, had variable shapes but well‐defined borders, and were less than 4 cm in diameter. These apparent pseudolesions were incidental findings in patients who had no evidence of significant liver disease, metastatic malignancy, or subsequent evidence of developing liver masses. In one patient, a second sonogram done 21 months after one such area was identified showed no change. In another patient, a computed tomogram done to clarify the finding was normal. Solitary hypoechoic areas in the liver at the porta hepatis fitting the above criteria should be interpreted cautiously. When there is no clinical suspicion of focal liver disease, these areas may be dismissed as insignificant or may be followed. If focal liver disease is suspected, the liver should be assessed by an additional method of examination.