Ultrasonographic features of tumor nodules in 64 patients with hepatocellular carcinoma and 87 with metastatic liver cancer were analyzed for differential diagnosis. Sonographic characteristics of hepatocellular carcinoma were the mosaic, posterior echo enhancement, and lateral shadow patterns, which were rarely observed in metastatic liver cancers. Small hepatocellular carcinomas, less than 3 cm in diameter, showed a hypoechoic pattern. Metastatic liver cancers originating from the gastrointestinal tract were frequently hyperechoic irrespective of their size and the bull's-eye-like pattern was specific for metastases from the lung. These results indicate that ultrasonography is useful for the differential diagnosis of hepatocellular carcinoma and metastatic liver cancer. Indexing Words: Ultrasonography Hepatocellular carcinoma . Metastatic liver cancer . Differential diagnosis Ultrasonography is one of the useful tools for detecting focal liver diseases and its advantages over other imaging modalities in early detection and characterization of small hepatocellular carcinoma have been However, it is not established how to differentiate hepatocellular carcinoma from metastatic liver cancer by ultrasonography alone. In this investigation we demonstrate the usefulness of ultrasonography in the differential diagnosis of hepatocellular carcinoma and metastatic liver cancer.
MATEPIALS AND METHODS
The subjects studied were 64 cases of hepatocellular carcinoma and 87 cases of metastatic liver cancer seen from 1981 to 1984. Patients with metastatic liver cancer consisted of 35 cases of colonic cancer, 29 of gastric cancer, and