Ultrasound will show multiple irregular hypoechoic lesions are seen throughout the liver. Smaller ductules may cause crowding of the interfaces, leading to hyperechoic lesions.
CT reveals multiple, irregular, low-attenuation lesions throughout the liver. On MRI, the lesions are well-defined, T1-hypointense, and T2-hyperintense (T2 hyperintensity is slightly less than that of water). There are usually mural nodules that are isointense on T1-weighted images and intermediate signal on T2-weighted images and which are between 1-2 mm. These nodules enhance.
Differential considerations include:
- Metastases: Lesions are usually not as uniform in shape and size as in multiple biliary hamartomas
- Microabscesses: Usually in immunosuppressed patients
- Juchems MS, Jeltsch M, Brambs HJ. Multiple cystic liver lesions on CT: multiple biliary hamartomas. Gut. 2008 Feb;57(2):144, 251.
- Tohmé-Noun C, Cazals D, Noun R, Menassa L, Valla D, Vilgrain V. Multiple biliary hamartomas: magnetic resonance features with histopathologic correlation. Eur Radiol. 2008 Mar;18(3):493-9.