Case 240:   Cirrhosis

Diagnostic Category:

Clinical Presentation:

48 year old man with acute lymphoblastic leukemia with incidental imaging finding. Patient has history of frequent blood transfusions.

US: Posterior hepatic notch sign

Imaging Findings:

Ultrasound shows classic posterior hepatic notch sign, which is an indentation in the visceral hepatic contour between the hypertrophic caudate lobe and posterior segments of the right lobe.

This can sign is typically seen in cirrhosis, but has been described as a congenital morphologic variation in 2% of cases [1].

1. Ito K, Mitchell D. Right posterior hepatic notch sign: a simple diagnostic MR finding of cirrhosis. J Magn Reson Imaging 2003;18: 561–566.