From May 1997 to May 1998, we conducted punctuation and aspiration of 30 cases of liver tumors under the guidance of ultrasound in order to diagnose by cytology. The result showed that, accurate diagnosis was 95% better than that given by the examination done with ultrasound (83.5%) and FP (52.5% positive). Punctuation and aspiration of liver tumors under the guidance of ultrasound is a simple method, easily to apply with high accuracy and allows quick and early diagnosis at the admission of the patient
Liver Neoplasms ; ultrasonography ; diagnosis

142 patients underwent diagnostic ultrasonography. Out of these, 100 patients have liver tumor and 42 have liver abscess. The prevalence is higher in male than in female and higher in 20-60 years of old than in other age groups. Liver tumor and abscess are more likely to be seen in right lobe than in left lobe with size of 5-10cm (55.7%). For liver abscess, sound reduction is more common (25.03%), while for liver tumor, sound combination and mixes are common types.
ultrasonography ; Liver Abscess ; diagnosis ; Liver Neoplasms

PURPOSE: The aim of this study was to investigate the influence of variations in fatty liver on the ultrasonographic detection of focal liver lesions. METHODS: A total of 229 patients with varying degrees of fatty liver and focal liver lesions and 200 patients with focal liver lesions but no fatty liver were randomly selected for inclusion in groups I and II, respectively. Findings of focal liver lesions identified on computed tomography were taken as the reference, and findings on ultrasonography were compared with them. RESULTS: The number of focal liver lesions in groups I and II were 501 and 413, respectively. The ultrasonographic detection rates of focal liver lesions in groups I and II were 86.8% (435/501) and 94.2% (389/413), respectively. Comparison of the detection of the focal lesions between patients with and without fatty liver or different grades of fatty liver were as follows: mild fatty liver (162/177) vs. liver without fat infiltration (389/413) (P=0.277); mild fatty liver (162/177) vs. moderate fatty liver (190/212) (P=0.604); mild fatty liver (162/177) vs. severe fatty liver (83/112) (P<0.001); moderate fatty liver (190/212) vs. liver without fat infiltration (389/413) (P=0.051); moderate fatty liver (190/212) vs. severe fatty liver (83/112) (P<0.001); severe fatty liver (83/112) vs. liver without fat infiltration (389/413) (P<0.001); and fatty liver (435/501) vs. liver without fat infiltration (389/413) (P<0.001). CONCLUSION: Mild and moderate fatty liver are not significantly associated with the visualization of the lesion, while severe fatty liver usually impairs the detection of focal lesions in the liver. If a patient with severe fatty liver is suspected to have a liver tumor, ultrasonography should only be chosen cautiously in case of a missed diagnosis.
Diagnosis ; Fatty Liver* ; Humans ; Liver ; Liver Neoplasms ; Ultrasonography*

PURPOSE: The purpose of this study was to examine the associations between ultrasonography (US) quality and clinical outcomes in patients undergoing surveillance for hepatocellular carcinoma. METHODS: Between 2008 and 2013, 155 patients were diagnosed with liver cancer during regular surveillance by positive US results (US group, n=82) or by computed tomography (CT) or magnetic resonance image (MRI) scanning as alternative modalities (CT/MRI group, n=73). The quality of the echogenic window, macronodularity of the liver parenchyma, and occurrence of surveillance failure (initial tumor diagnosis beyond the Milan criteria or at Barcelona Clinic Liver Cancer stage B or C) were evaluated. Overall survival was compared according to whether surveillance failure occurred. RESULTS: The patients in the CT/MRI group with negative US results had a higher proportion of parenchymal macronodularity on US than those in the US group (79.5% vs. 63.4%, P=0.028). Surveillance failure tended to be more common in the US group than in the CT/MRI group (40.2% vs. 26.0% by the BCLC staging system [P=0.061]). In the US group, surveillance failure occurred more frequently when the echogenic window was inadequate (50.0% vs. 19.4% by the Milan criteria [P=0.046]). Significantly poorer 5-year overall survival was associated with surveillance failure (P≤0.001). CONCLUSION: Parenchymal macronodularity hindered the detection of early-stage tumors during US surveillance. Using an alternative imaging modality may help prevent surveillance failure in patients with macronodular parenchyma on US. Supplemental surveillance strategies than US may also be necessary when the echogenic window is inadequate.
Carcinoma, Hepatocellular ; Diagnosis ; Humans ; Liver ; Liver Neoplasms ; Population Surveillance ; Ultrasonography

Colorectal cancer is currently one of the most common digestive system tumors, and the liver is the most common metastatic site of colorectal cancer. In recent years, with the continuous development of the multidisciplinary treatment for colorectal cancer patients, there are quite a few cases of disappearing liver metastases (DLM) after receiving preoperative chemotherapy (or combined targeted drug therapy), and the diagnosis and treatment of DLM is currently still a very challenging and controversial topic. This article sorts out the related researches on DLM in recent years, mainly including the following 4 aspects: (1) The factors associated with DLM, including the size and number of liver metastases, chemotherapy regimens and cycles, targeted therapy drugs, and the pattern of liver metastases, Ras/Braf status and the location of the primary lesion. (2) The relationship between DLM and true complete response (pathological complete response and persistent clinical complete response), and the related predictive factors of pathological complete response. (3) Clinical evaluation of DLM: preoperative evaluation includes ultrasound, CT, MRI, and PET, while intraoperative evaluation includes intraoperative exploration, intraoperative ultrasound, and augmented reality. (4) DLM treatment strategies, including surgical treatment, local treatment, non-surgical treatment and individualized treatment.
Colorectal Neoplasms ; Humans ; Liver Neoplasms ; Magnetic Resonance Imaging ; Ultrasonography

Because US plays a key role in the initial evaluation of hepatic hemangiomas,knowledge of the entire spectrum of US appearances of these tumors is impor-tant. Most hemangiomas have a distinctive US appearance, and even with those with atypical appearances on conventional gray-scale US, specific diagnoses can be made using pulse-inversion harmonic US with contrast agents. In this essay,we review the spectrum of US appearances of hepatic hemangiomas on conven-tional gray-scale, power Doppler, and pulse-inversion harmonic US with contrast agents.
Adult ; Aged ; Contrast Media ; Female ; Hemangioma/*ultrasonography ; Human ; Liver Neoplasms/*ultrasonography ; Male ; Middle Age ; Ultrasonography, Doppler ; Ultrasonography, Doppler, Color

Fibrolamellar hepatocelluar carcinoma is a distinct clinicopathologic variant of hepatocellular carcinoma. We describe here the sonographic and CT findings of fibrolamellar hepatocellular carcinoma in a 17-year-old patient that mimicked hepatic malignant lymphoma due to the multiple small hypoattenuating nodules and extensive lymphadenopathy that we observed. We also include a review of the relevant literatures.
Adolescent ; Carcinoma, Hepatocellular* ; Humans ; Liver Neoplasms ; Lymphatic Diseases ; Lymphoma* ; Ultrasonography

PURPOSE: The aim of this study was to define the capsules of synchronous multicentric small hepatocellular carcinomas (HCCs) with use of high-frequency intraoperative ultrasonography (IOUS). METHODS: Among the 131 consecutive patients undergoing hepatic resection and high-frequency IOUS for HCC, 16 synchronous multicentric small HCCs in 13 patients were histologically diagnosed in the resected specimens. High-frequency IOUS and pathologic findings of these lesions were compared, with particular focus on the presence and appearance of the capsule in or around each lesion. RESULTS: Synchronous multicentric small HCCs were pathologically classified into distinctly nodular (n=12) or vaguely nodular (n=4) types. All 12 distinctly nodular HCCs including six subcentimeter lesions showed detectable capsules on high-frequency IOUS and pathology. The capsules appeared as a hypoechoic rim containing hyperechoic foci (n=6), hypoechoic rim (n=5), or hyperechoic rim (n=1) with varying degrees of coverage around each lesion. Histologically, the capsules were composed of a combination of one to four layers consisting of a fibrous capsule, peritumoral fibrosis, prominent small vessels, and entrapped hepatic parenchyma. CONCLUSION: Synchronous multicentric small HCCs with distinctly nodular type, even at subcentimeter size, can show capsules with varying coverage and diverse echogenicity on high-frequency IOUS.
Capsules ; Carcinoma, Hepatocellular* ; Fibrosis ; Humans ; Liver Neoplasms ; Pathology ; Ultrasonography*

Intraoperative ultrasonography (IOUS) has been widely utilized in hepatic surgery both as a diagnostic technique and in the course of treatment. Since IOUS involves direct-contact imaging of the target organ, it can provide high spatial resolution without interference from the surrounding structures. Therefore, IOUS may improve the detection, characterization, localization, and local staging of hepatic tumors. IOUS is also a real-time imaging modality capable of providing interactive information and valuable guidance in a range of procedures. Recently, contrast-enhanced IOUS, IOUS elastography, and IOUS-guided hepatic surgery have attracted increasing interest and are expected to lead to the broader implementation of IOUS. Herein, we review the various applications of IOUS in the diagnosis and management of focal hepatic lesions.
Diagnosis* ; Elasticity Imaging Techniques ; Intraoperative Care ; Liver Neoplasms ; Ultrasonography*

OBJECTIVETo observe the performance of liver metastases with contrast-enhanced ultrasound (CEUS) and assess its clinical application.

METHODSTwenty-one patients with 21 untreated liver metastases underwent CEUS with low mechanical index imaging. The characteristic appearances of CEUS in different vascular phases were observed.

RESULTSOf 21 metastases, 19 (90.5%) were identified as fast-in and fast-out enhancement pattern. In the arterial phase, all the 21 lesions showed enhancement but with varied appearances: 12 (57.1%) showed early diffuse enhancement, 8 (38.1%) showed ring-like enhancement, and the remaining one lesion of large size showed slowly enhomogenous minor enhancement. In the late phase, sharp defects were found in 20 lesions (95.2%), and more lesions were detected in 3 patients (14.3%).

CONCLUSIONCEUS can show the characteristic appearance of liver metastases, and can be used for the screening and diagnosis of liver cancers.