Histopathological correlation of ultrasound appearances of liver metastases

We reviewed ultrasound examinations of the liver performed at Yale--New Haven Hospital on patients with biopsy-proven tumors since January 1, 1977, to correlate the ultrasonic appearances with histology. Liver metastases appeared as sonolucent lesions in 37.5% of patients, as mixed sonolucent/echogenic lesions in 37.5%, and as solely echogenic in only 25%. We found a limited correlation between the echogenic pattern of the ultrasound scans and histology. The majority of echogenic metastases were from colonic primaries (54%) or hepatomas (25%). Metastases from lymphomas were extremely sonolucent and sarcomas frequently demonstrated central necrosis. Calcified metastases from mucin-secreting adenocarcinoma of the colon appeared as dense lesions with distal shadowing.