Benign malformations of biliary tract

Synonyms: von Meyenburg complex, bile duct hamartoma

Grayscale ultrasound

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  Numerous small, hypoechoic or hyperechoic foci uniformly distributed throughout liver

  
  
  
  
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    Leads to inhomogeneous and coarse appearance of liver echotexture

  
  
  
  
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  Multiple echogenic foci, often with associated comet-tail artifacts

  
  
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  Typically smaller lesions appear as echogenic foci whereas larger lesions appear cystic

  
  
  
  
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    Often extent of echogenic foci on ultrasound is greater than anticipated compared to correlative CT or MR

  
  

Color Doppler ultrasound

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  Twinkling artifact may be seen

MRCP

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  Numerous scattered, tiny cysts without communication between lesions and biliary tree

Multiple simple hepatic cysts

Multiple small hepatic metastasis

Hepatic microabscesses

Autosomal dominant polycystic liver disease

Caroli disease

May be misdiagnosed as multiple hepatic metastasis, microabscesses, cirrhosis, lymphoma, leukemia, etc. at initial imaging

No further evaluation necessary when seen as isolated finding in healthy, nononcologic patient

Linear transducers may better demonstrate biliary hamartomas than curved or vector transducers due to higher frequency and greater resolution