liver metastases
Introduction
Introduction The liver is an organ that is prone to metastasis of various malignant tumors and is one of the most prevalent sites for metastatic cancer. Liver metastasis refers to the non-hepatic primary tumor that can be transferred to the liver via the blood or lymphatic pathway. Common liver metastases are mostly from the digestive tract, lung, pancreas, kidney and breast.
Cause
Cause
Each tumor metastasized to the liver, and the common liver metastasis tumors were mostly from the digestive tract, lung, pancreas, kidney and breast.
Examine
an examination
Related inspection
Serum -glutamyltranspeptidase A fetal globulin test serum -glutamyltranspeptidase (-GTP) serum glycyl glutamyl-dipeptide aminopeptidase (GPDA) tumor contrast angiography
1. Ultrasound performance:
Single or multiple nodules in the liver can be low echo, strong echo or uneven echo, showing a "bull-eye" change.
2. CT performance:
(1) plain scan: single or multiple round or lobulated masses in the liver, mostly showing low density, mostly in lower density areas with low density lesions, thus showing concentric or contoured double The outline is characterized by it. The boundaries are mostly ambiguous.
(2) Enhancement: The tumor is strengthened, the boundary is clear, the central density is lower than the surrounding part, and the edge of the tumor can show the annular irregular strengthening, and some of the "bull eye sign" can be seen, which is characterized by low density at the center of the lesion and high density enhancement at the edge. The outermost layer density is lower than the liver parenchyma.
(3) A small number of liver metastasis tumors such as cervical cancer and esophageal cancer have almost all necrosis and liquefaction, which is cystic density, and the wall is thick or irregularly strengthened. In addition, liver metastatic tumors such as colorectal cancer and ovarian cancer may also be combined with calcification, which is characterized by punctate, plaque-like, feather-like high-density lesions.
3. MRI performance:
It is also sensitive to smaller metastatic cancers, and T2-weighted images show more high signals.
Diagnosis
Differential diagnosis
Differential diagnosis of liver metastasis:
1. Primary hepatocellular carcinoma: Primary carcinoma of the liver is one of the common malignant tumors in China. The mortality rate is high, ranking third in the stomach and esophagus in the rank of malignant tumor death, and second in the rural areas in some areas, second only to gastric cancer. China's annual death from liver cancer is about 110,000, accounting for 45% of the world's liver cancer deaths. Because of the detection of serum alpha-fetoprotein (AFP) combined with ultrasound imaging for high-risk population monitoring, liver cancer can be diagnosed in the sub-clinical stage, and the long-term effect of early resection is particularly significant. Coupled with active comprehensive treatment, the five-year survival rate of liver cancer has been significantly improved.
2, liver abscess: liver abscess hepatic abscess, liver abscess can be caused by the infection of the tissue amoeba or bacterial infection. The incidence of amebic liver abscess is closely related to amoebic colitis, and most of the abscess is single; bacterial bacterial invasion of bacterial liver abscess can be caused by direct spread of intra-abdominal infection, in addition to sepsis, but also due to umbilical Infection through the umbilical blood vessels, the portal vein into the liver, biliary aphids can also be the cause of bacterial liver abscess. Common bacteria are Staphylococcus aureus, Streptococcus, and the like.
Diagnosis of liver metastases:
1. Ultrasound performance:
Single or multiple nodules in the liver can be low echo, strong echo or uneven echo, showing a "bull-eye" change.
2. CT performance:
(1) plain scan: single or multiple round or lobulated masses in the liver, mostly showing low density, mostly in lower density areas with low density lesions, thus showing concentric or contoured double The outline is characterized by it. The boundaries are mostly ambiguous.
(2) Enhancement: The tumor is strengthened, the boundary is clear, the central density is lower than the surrounding part, and the edge of the tumor can show the annular irregular strengthening, and some of the "bull eye sign" can be seen, which is characterized by low density at the center of the lesion and high density enhancement at the edge. The outermost layer density is lower than the liver parenchyma.
(3) A small number of liver metastasis tumors such as cervical cancer and esophageal cancer have almost all necrosis and liquefaction, which is cystic density, and the wall is thick or irregularly strengthened. In addition, liver metastatic tumors such as colorectal cancer and ovarian cancer may also be combined with calcification, which is characterized by punctate, plaque-like, feather-like high-density lesions.
3. MRI performance:
It is also sensitive to smaller metastatic cancers, and T2-weighted images show more high signals.
