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Dynamic Sonography of Hepatic Tumors

¹ All authors: Department of Cancer Survey, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3, Nakamichi, Higashinari, Osaka, 537-8511 Japan.

View larger version (15K): [in a new window]   Fig. 1. —Chart shows protocol for dynamic hepatic sonography.

View larger version (175K): [in a new window]   Fig. 2B. —66-year-old man with 12-mm-diameter hepatocellular carcinoma in right posterior segment of liver. Arterial-phase dynamic sonogram obtained 17 sec after contrast medium injection reveals tumor enhancement gradually extending to whole area of tumor (arrowhead).

View larger version (146K): [in a new window]   Fig. 3B. —74-year-old man with 20-mm-diameter hepatocellular carcinoma in right anterior segment of liver. Arterial-phase dynamic sonogram obtained 16 sec after contrast medium injection shows feeding artery (arrow) entering into tumor. Mosaic enhancement of tumor (arrowheads) is present.

View larger version (163K): [in a new window]   Fig. 4A. —77-year-old man with 80-mm-diameter metastasis from colon cancer in left medial segment of liver. Arterial-phase dynamic sonogram obtained 21 sec after contrast medium injection shows right anterior and left medial branches of hepatic artery (arrows) are enhanced. Peripheral area of tumor (arrowheads) shows ring enhancement.

View larger version (170K): [in a new window]   Fig. 4B. —77-year-old man with 80-mm-diameter metastasis from colon cancer in left medial segment of liver. Portal-phase dynamic sonogram obtained 46 sec after contrast medium injection shows that in this phase, horizontal portion of portal vein (arrows), rather than arterial branches, is enhanced. Ring enhancement (arrowheads) of tumor area lasts until portal phase.

View larger version (111K): [in a new window]   Fig. 5. —45-year-old man with 40-mm-diameter hemangioma in right posterior segment of liver. Portal-phase dynamic sonogram obtained 37 sec after contrast medium injection reveals puddle enhancement (arrowheads) in tumor area.

View larger version (135K): [in a new window]   Fig. 4C. —77-year-old man with 80-mm-diameter metastasis from colon cancer in left medial segment of liver. Liver-parenchymal-phase dynamic sonogram reveals tumor as clear defect.

View larger version (147K): [in a new window]   Fig. 2D. —66-year-old man with 12-mm-diameter hepatocellular carcinoma in right posterior segment of liver. On liver-parenchymal-phase dynamic sonogram, tumor (arrowhead) is shown as obscure defect.

View larger version (141K): [in a new window]   Fig. 3D. —74-year-old man with 20-mm-diameter hepatocellular carcinoma in right anterior segment of liver. Liver-parenchymal-phase dynamic sonogram shows reticular enhancement in tumor (arrowheads).

View larger version (165K): [in a new window]   Fig. 6B. —57-year-old man with 20-mm-diameter focal fat-spared region in medial segment of liver. Liver-parenchymal-phase dynamic sonogram shows that focal lesion cannot be distinguished because whole liver is strongly enhanced, including focal region (arrowheads).

View larger version (163K): [in a new window]   Fig. 2A. —66-year-old man with 12-mm-diameter hepatocellular carcinoma in right posterior segment of liver. Arterial-phase dynamic sonogram obtained 11 sec after contrast medium injection reveals enhancement of tumor (arrow) first visible near feeding artery at edge of hypoechoic tumor (arrowheads).

View larger version (180K): [in a new window]   Fig. 2C. —66-year-old man with 12-mm-diameter hepatocellular carcinoma in right posterior segment of liver. Portal-phase dynamic sonogram obtained 29 sec after contrast medium injection reveals echogenicity of surrounding liver gradually increasing and tumor (arrowhead) becoming isoechoic compared with surrounding liver.

View larger version (171K): [in a new window]   Fig. 3C. —74-year-old man with 20-mm-diameter hepatocellular carcinoma in right anterior segment of liver. Portal-phase dynamic sonogram obtained 25 sec after injection shows enhancement appearing in portal branch (arrow). With gradual increase of echo level of liver, tumor is visualized as hypoechoic lesion (arrowheads) compared with surrounding liver.

View larger version (140K): [in a new window]   Fig. 3A. —74-year-old man with 20-mm-diameter hepatocellular carcinoma in right anterior segment of liver. Dynamic sonogram obtained before enhancement reveals round hypoechoic lesion.

View larger version (177K): [in a new window]   Fig. 3E. —74-year-old man with 20-mm-diameter hepatocellular carcinoma in right anterior segment of liver. Photograph of histologic specimen shows cut surface of tumor removed from surgically resected liver. Note that fibrous capsule and septa are in pattern resembling reticular enhancement seen in D.

View larger version (184K): [in a new window]   Fig. 6A. —57-year-old man with 20-mm-diameter focal fat-spared region in medial segment of liver. Dynamic sonogram obtained before enhancement reveals hypoechoic region (arrowheads) anterior to transverse portion of portal vein.

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