Hillman B J, Smith E H, Gammelgaard J, Holm H H
Gastrointest Radiol. 1979 Nov 15;4(4):361-5. doi: 10.1007/BF01887558.
Characterization of the source of hepatic malignancy would be useful in directing a patient's workup, saving time and expense. We attempted to correlate the echographic appearance of malignant hepatic masses with the pathologic (44 patients) or clinical (1 patient) diagnosis in 45 consecutive patients scanned to evaluate this problem. In 31 patients the lesions were hyperechoic (28) or predominantly hyperechoic with central lucency. Of these lesions, 25 represented metastases from adenocarcinoma of the colon (17), pancreas (6), or unknown origin (2). Six patients with metastatic adenocarcinoma had predominantly echolucent lesions. Of the 14 malignancies of other histologic types, 6 were largely hyperechoic and could not be distinguished from adenocarcinoma metastases. No correlations could be drawn between the ultrasound patterns and the tumor source in this diverse group fo malignancies. In eight patients receiving chemotherapy, sequential examinations failed to reveal any alteration in the echographic patterns of their lesions. These results indicate that the ultrasound appearance of hepatic malignancy lacks specificity in defining the organ of origin. Such factors as homogeneity, vascularity, or desmoplastic response may be more important than cell type in producing the echographic pattern.
明确肝脏恶性肿瘤的来源对于指导患者的检查、节省时间和费用是有用的。我们试图将45例连续接受扫描的患者肝脏恶性肿块的超声表现与病理诊断（44例患者）或临床诊断（1例患者）进行关联，以评估这个问题。在31例患者中，病变为高回声（28例）或主要为高回声伴中央透亮区。在这些病变中，25例为结肠癌（17例）、胰腺癌（6例）或来源不明（2例）的转移瘤。6例转移性腺癌患者的病变主要为无回声。在其他组织学类型的14例恶性肿瘤中，6例在很大程度上为高回声，无法与腺癌转移瘤区分开来。在这组多样的恶性肿瘤中，无法在超声图像模式与肿瘤来源之间建立关联。在8例接受化疗的患者中，连续检查未能发现其病变超声图像模式有任何改变。这些结果表明，肝脏恶性肿瘤的超声表现缺乏确定起源器官的特异性。在产生超声图像模式方面，诸如均匀性、血管分布或促结缔组织增生反应等因素可能比细胞类型更重要。
