Figure 11a.

US-3 positive observation in a 63-year-old man with HCV infection and cirrhosis. (a) Transverse grayscale US image of the left lobe shows mild heterogeneity and coarse echotexture of the liver without a suspicious observation. (b) Longitudinal gray-scale US image of the right lobe shows asymmetric refractive shadowing (*) and a large area of parenchymal distortion, heterogeneity, and absent vessels, which are suspicious findings that warrant further evaluation. This demonstrates the clinical utility of comparing the right and left lobes of the liver. Subsequent multiphase contrast-enhanced CT images (not shown) showed infiltrative HCC in the right lobe of the liver.