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Parenchymal distortion in a 64-year-old man with HCV infection and cirrhosis. Sagittal gray-scale US image of the right lobe of the liver shows a large area of parenchymal distortion, with areas of decreased echogenicity (arrows) and loss of normal hepatic vessels. This observation was categorized as US-3 positive and was subsequently evaluated at multiphase contrast-enhanced MRI (not shown), which showed an infiltrative HCC corresponding to this observation.
