Focal Hyperechoic Hepatic Lesions in Northern Region of Saudi Arabia: Prevalence, Radiologic Features, and Clinical Relevance

<b>Background:</b> This study investigates the incidence and radiological features of hyperechoic hepatic lesions in northern Saudi Arabia, using ultrasound (US) and computed tomography (CT). The aim is to evaluate the frequency of occurrence of these lesions and to describe the imaging characteristics of different focal hepatic lesions. <b>Methods:</b> A retrospective study was performed on 191 patients diagnosed with hyperechoic hepatic lesions at a single centre. Imaging data from ultrasound and CT scans were analyzed, including lesion number, segmental distribution, echogenicity, enhancement patterns, size, and type. Statistical methods included incidence calculation, variable correlation, and Pearson's Chi-square test, with significance set at <i>p</i> < 0.05. <b>Results:</b> The incidence of hyperechoic hepatic lesions was 1.27%, with a higher prevalence in females (57.59%) and a median age of 40 years. Hemangiomas were the most common type of lesion (94.77%). Most lesions were solitary (87.43%) and benign (96.86%), with malignant lesions accounting for only 3.14%. A statistically significant age difference was observed between patients with benign and malignant lesions (<i>p</i> < 0.05). <b>Conclusions:</b> Focal hyperechoic hepatic lesions are relatively common in the northern Saudi population, with haemangiomas being the predominant benign entity. These lesions occur more frequently in women and are usually solitary. Ultrasound, complemented by problem-solving techniques such as contrast-enhanced ultrasound (CEUS) or triphasic CT, effectively characterizes hyperechoic hepatic lesions and guides clinical decisions regarding further evaluation or management.