Ultrasound appearances of hepatic metastases
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Ultrasound appearance of liver metastases can have bewildering variation.Caveat: Presence of hepatic steatosis can affect the sonographic appearance of liver lesions.
Patterns do exist between ultrasound appearance of the liver metastases and the likely primary, which is sometimes helpful in directing a search for an unknown primary, as well as helping distinguish between benign lesions and metastatic disease from a particular primary:
- hypoechoic: most common ~65%
- hyperechoic
- peripheral halo: a hypoechoic halo is a concerning feature, sometimes called the target or bull's eye lesion/sign
- common in many
- lung cancer
- calcified
- mucinous adenocarcinoma
- gastrointestinal
- ovarian mucinous adenocarcinoma
- mucinous adenocarcinoma
- cystic
- poorly defined (infiltrative)
- associated intrahepatic biliary dilation
Contrast-enhanced ultrasound
May be useful to increase conspicuity of lesions and/or guide biopsy
- arterial phase: variable depending on primary
- hypovascular: gastrointestinal, ovarian, pancreatic adenocarcinoma
- hypervascular: neuroendocrine, melanoma, renal
- portal venous phase
- "wash out" (decreased echogenicity relative to background liver); may be the most useful phase for detection
-<p><strong>Ultrasound appearance of liver metastases</strong> can have bewildering variation.<br>Caveat: Presence of <a title="Hepatic steatosis" href="/articles/hepatic-steatosis">hepatic steatosis</a> can affect the sonographic appearance of liver lesions.</p><p>Patterns do exist between ultrasound appearance of the <a href="/articles/hepatic-metastases-1">liver metastases</a> and the likely primary, which is sometimes helpful in directing a search for an unknown primary, as well as helping distinguish between benign lesions and metastatic disease from a particular primary:</p><ul>- +<p><strong>Ultrasound appearance of liver metastases</strong> can have bewildering variation.<br>Caveat: Presence of <a href="/articles/hepatic-steatosis">hepatic steatosis</a> can affect the sonographic appearance of liver lesions.</p><p>Patterns do exist between ultrasound appearance of the <a href="/articles/hepatic-metastases-1">liver metastases</a> and the likely primary, which is sometimes helpful in directing a search for an unknown primary, as well as helping distinguish between benign lesions and metastatic disease from a particular primary:</p><ul>
-</ul><h5><a title="Contrast-enhanced ultrasound" href="/articles/contrast-enhanced-ultrasound-2">Contrast-enhanced ultrasound</a></h5><p>May be useful to increase conspicuity of lesions and/or guide biopsy</p><ul>- +</ul><h5><a href="/articles/contrast-enhanced-ultrasound-2">Contrast-enhanced ultrasound</a></h5><p>May be useful to increase conspicuity of lesions and/or guide biopsy</p><ul>
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