[Sonographic diagnosis in primary cancer of the liver]

The sonographic findings and their contribution to differential diagnosis and tumor staging are described in 34 patients with hepatocellular carcinoma and in 12 cases of cholangiocellular carcinoma. In most cases of hepatocellular carcinoma the liver was diffusely involved at presentation, whilst in cholangiocarcinoma tumor growth was usually limited to a single lobe. Over 60% of the hepatocellular carcinomas were predominantly echogenic. The cholangiocarcinomas all presented with a highly echogenic tumor in combination with uni- or bilaterally dilated intrahepatic bile ducts. In 20 patients estimation of liver size by the ultrasound-measurement of liver span in the right midclavicular line is compared with ultrasound-measured liver volume and its value in assessing response to therapy. Volume changes in response to therapy were demonstrated in five patients with hepatocellular carcinoma. In alpha-fetoprotein positive tumors they corresponded with changes in alpha-fetoprotein levels.