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ULTRASONOGRAPHY
IMAGING OF LIVER METASTASES IN COLORECTAL CANCER
Trifunoviæ
J, Salma S, Nikolin B, Kukiæ B.
Institute
of Oncology Sremska Kamenica, Sremska Kamenica, Serbia
and Montenegro
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ABSTRACT
In
Western countries metastases are the most frequent liver tumors
and metastatic liver disease appears 18 to 20 times more often than
primary carcinoma. Approximately one third of all primary malignant
tumors, including colorectal cancer, metastasize in liver. The aim
of our study was to determine the importance of ultrasonography
and needle biopsy findings in diagnostic evaluation of liver metastases.
Our study included 34 patients with ultrasonography suspected metastatic
lesions in liver. Evaluation criteria included size, number, contours
and echostructure of metastatic lesions in liver. Echostructure,
being the most important parameter for the evaluation of metastases,
comprised of a number of echogenic types. All parameters related
to the metastatic appearance in liver were correlated to primary
tumor. Ultrasound-guided needle biopsy was done in case of 19 patients,
and the obtained findings were correlated to ultrasonography findings
and final diagnosis of primary tumor. Patients were classified according
to the site of primary tumor. The most frequent primary tumors with
verified metastases were colorectal and breast cancer; pancreatic
carcinoma, malignant melanoma, gastric cancer and lymphoma were
also found. Differential diagnosis of suspect metastatic lesions
in liver confirmed two liver hemangiomas also.Single, multiple and
diffuse liver metastases of various shapes, contours and echostructure
were ultrasonographically verified. Ultrasonography image of liver
metastases was described as a target-type lesion, hyperechogenic
or hypoechogenic lesion, calcification, cystiform lesions, and other
types of mixed echogenicity. Hypergenic metastases and target-type
lesions were the most frequent sonographic images of liver metastases
due to colorectal cancer, but other echostructures were also found.
Ultrasonography is important and usually sufficient for the diagnosis
of liver metastases. In majority of patients ultrosonography image
of metastasis is enough for making decision about the type of tumor.
Metastases of some tumors are often characterized with a particular
ultrasound echostructure. However, the analysis of the correlation
between ultrasonography imaging of metastasis and primary tumor
leads to the conclusion that a definite and reliable correlation
actually does not exist. |
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Keywords:
Colorectal cancer, Liver metastases, Ultrasonography |
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