[Diagnosis of space-occupying lesions of the liver. What is the value of diagnostic imaging?].
Ultrasound in B-mode or tissue harmonic imaging is the procedure of first choice for investigating the liver. If US is employed to screen for metastatic disease, B-mode contrast harmonic imaging should be used in addition to conventional ultrasound. For the diagnosis "space-consuming liver lesion", the echogenicity and clinical aspects determine the further diagnostic procedure. Echogenic liver lesions in patients with known malignant disease, and echo-poor or "echo-complex" lesions always indicate a need for further spiral CT or MRT investigations. In tumour patients, spiral CT offers the advantage of enabling simultaneous evaluation of the parenchyma, and abdominal staging. Primary SPIO-amplified MRT is indicated whenever the primary interest is the detection of space-consuming liver lesions. In the case of echogenic lesions in the absence of underlying malignant disease, US follow-up suffices. Here, differential diagnostic information can be gained from the vascular distribution patterns of a lesion obtained with color-coded duplex US. Hepatic lesions that, after exhausting all diagnostic imaging procedures remain suspicious, require biopsy.
Beissert
M
M
Institut für Röntgendiagnostik der Universität Würzburg. beissert@roentgen.uni-wuerzburg.de
Jenett
M
M
Kessler
C
C
D003937:Diagnosis, Differential; D003952:Diagnostic Imaging; D006801:Humans; D007089:Image Enhancement; D008099:Liver / Q000473:pathology; D008113:Liver Neoplasms / Q000175:diagnosis*; D011237:Predictive Value of Tests