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Hepatic pseudotumors in patients with ascites.

Echogenic hepatic pseudotumors have been described in three patients with cirrhosis and ascites. A nodular liver surface surrounded by a non‐uniform depth of ascites causes a focal concave area to transmit sound in a manner analogous to the posterior wall of a cyst. The area of increased echogenicity, caused by decreased attenuation, is demarcated from adjacent liver tissue by a refractive artifact. This echogenic pseudomass should not be interpreted as representing pathologic change. One can verify that this is an artifact by changing the transducer angle and position. When the entering sound does not traverse the ascites, the liver echogenicity becomes homogeneous.