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Diagnostic ultrasound ( PDFDrive )

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126 PART II Abdominal and Pelvic Sonography

A

B

C

D E F

G

H

I

FIG. 4.59 Liver Metastases in Three Patients. Top row, Focal liver masses: most common variety and easiest to appreciate. (A) Sagittal

image of the right lobe shows a well-deined and lobulated hypoechoic mass. (B) Sagittal image of the left lobe shows conluent masses in segment

3. (C) Transverse image shows the two focal hypoechoic masses separated by normal liver. Middle row, Rare geographic pattern of metastases.

(D) and (E) Subcostal views show the right and left lobes of the liver. A sharp geographic or maplike border separates the normal echogenic liver

from the hypoechoic tumor. The distribution and echogenicity variation suggest possible fatty change or perfusion abnormality. (F) Conirmatory

computed tomography (CT) scan. Bottom row, Diffuse tumor involvement: often the most dificult to appreciate on ultrasound, as shown here.

(G) Transverse sonogram; (H) similar view with greater magniication. Both images show a coarse liver parenchyma that is more suggestive of

cirrhosis than the extensive tumor shown on (I) CT scan.

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