[The outline of diagnostic procedures in the cases of focal lesions in liver].
The majority of focal lesions in liver is typified by none or scant clinical symptoms and the first diagnosis is usually made during the ultrasonographic examination (USG). The first examinations usually performed in these cases are: the assignment of neoplastic markers in the serum (alpha-fetoprotein--AFP, carcinoembryonal antigen--CEA), imaging methods (USG, USG using Doppler effect, computer tomography--CT) and isotopic methods. The goal of the study is to present the proposal of outline of diagnostic procedures in the cases of focal lesions in liver based on the data from references. As the first step of diagnostic procedures non-invasive screening examinations are recommended (AFP, CEA, USG, USG using Doppler effect, CT of the abdominal cavity). The increase of the concentration of CEA in serum can suggest the metastatic tumour from the large bowel. The increase of the concentration of AFP makes possible to distinguish hepatocellular carcinoma from other malignant lesions. USG is useful to detect focal lesions which diameter is over 1.5 cm. USG has limited value to qualify the nature of the tumour. On the base of echogenicity of examined lesion we are able to make an initial selection to distinguish single from multiple and cystiform from solid lesions. USG using Doppler effect to detect vessel-signal helps to distinguish sound parenchyma from pathologically changed tissues. CT qualifies focus or dissemination of the disease. After screening examinations we use specialistic or invasive methods which are usually performed in the clinical circumstances. CT connected with angiography has a high sensitivity in detecting hepatocellular carcinoma. Isotopic methods help to confirm the depletion of sound parenchyma of the liver (colloidal scintigraphy) as well as sensitive and specific diagnostics of some types of neoplasms (scintigraphy using labelled erythrocytes to detect angioma). Guided fine-needle biopsy under the USG control makes possible to evaluate the nature of the tumour by means of cytological examination. Diagnosis made by means of sonolaparoscopy and nuclear magnetic resonance (NMR) is described in references, but these examinations have not been used in Poland by this time. Methods which were presented make possible to assign the outline of diagnostic procedures. The outline will help to differentiate precisely and quickly the nature and size of focal lesions in liver.
Błaszczyńska
M
M
Katedry i Kliniki Gastroenterologii Slaskiej Akademii Medycznej w Katowicach.
Rybczyńska
E
E
Szaflarska
M
M
D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography