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Question answered:05/12/07 Warning! this question is over two years old.
We found a number of conditions associated with a hyperechoic liver, which we’ll highlight below. However, it should be noted that we were unable to locate a single robust review article and the literature we found sparse. As such we have little confidence that we have found all (or even a significant number of) causes. Therefore, we recommend you discuss this with the laboratory that gave you the result.
With US, metastases can be hypoechoic, hyperechoic, cystic, or diffuse [1]
Large regenerative nodule [2]
Hydatid cyst of the liver [3]
A focal fatty liver change may be associated with several conditions related to diffuse hepatic steatosis, such as a diffuse fatty liver change. Using ultrasonography, the focal fatty liver change appears more frequently as hyperechoic and less frequently as hypoechoic areas in the liver. [4]
We did find an extract, via Google Books, of ‘Differential Diagnosis in Ultrasound’ which gave the following image [5]:
NOTE: As these weren’t mentioned we’ve ignored reference to patients with trauma and/or pregnant.
References
1) http://www.guideline.gov/summary/summary.aspx?doc_id=8295&nbr=4627&ss=6&xl=999
2) http://pmid.us/16246206
3) http://pmid.us/16168269
4) http://pmid.us/12239916
5) http://books.google.com/books?id=eGRNxf8wCoIC&pg=PT104&lpg=PT104&dq=hyperechoic+liver&source=web&ots=EO3KqdD8pJ&sig=BAzPdlbVpPY_PSD1Fv5DvX3n07c
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