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Ultrasonography of liver tumors
Purpose
detection and characterization of hepatic tumors
Ultrasonography of liver tumors involves two stages: detection and characterization.[1]
Tumor detection is based on the performance of the method and should include morphometric information (three axes dimensions, volume) and topographic information (number, location specifying liver segment and lobe/lobes). The specification of these data is important for staging liver tumors and prognosis.[2]
Tumor characterization is a complex process based on a sum of criteria leading towards tumor nature definition. Often, other diagnostic procedures, especially interventional ones are no longer necessary. Tumor characterization using the ultrasound method will be based on the following elements: consistency (solid, liquid, mixed), echogenicity, structure appearance (homogeneous or heterogeneous), delineation from adjacent liver parenchyma (capsular, imprecise), elasticity, posterior acoustic enhancement
effect, the relation with neighboring organs or structures (displacement, invasion), vasculature (presence and characteristics on Doppler ultrasonography and contrast-enhanced ultrasound (CEUS).[citation needed]
The substrate on which the tumor condition develops (if the liver is normal or if there is evidence of diffuse liver disease) and
the developing context (oncology, septic) are also added. Particular attention should be paid
to the analysis of the circulatory bed. Microcirculation investigation allows for discrimination between benign and malignant tumors. Characteristic elements of malignant
circulation are vascular density, presence of vessels with irregular paths and size, some of
them intercommunicating, some others blocked in the end with "glove finger" appearance,
the presence of arterio-arterial and arterio-venous shunts, lack or incompetence of arterial
precapillary sphincter made up of smooth musculatures.[citation needed]
Diagnosis and characterization of liver tumors require a distinct approach for each group of
conditions, using the available procedures discussed above for each of them. The correlation
with the medical history, the patient's clinical and functional (biochemical and
hematological) status are important elements that should also be considered.[citation needed]
^Siederdissen, C.H.Z; Potthoff, A (February 2020). "[Sonographic diagnostics of liver tumors]". Internist (Berl). 61 (2): 115–122. doi:10.1007/s00108-019-00728-5. PMID 31925480. S2CID 210671524. Retrieved 4 July 2021.
^Siederdissen, C.H.Z; Potthoff, A (February 2020). "[Sonographic diagnostics of liver tumors]". Internist (Berl). 61 (2): 115–122. doi:10.1007/s00108-019-00728-5. PMID 31925480. S2CID 210671524. Retrieved 4 July 2021.
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