Diagnostic Ultrasound - Abdomen and Pelvis

Hepatocellular Carcinoma
(Left) Transverse grayscale
and color Doppler ultrasound
of the liver show a solid,
hypoechoic hepatocellular
carcinoma st with internal
vascularity ſt. (Right)
Longitudinal and transverse
US of the left lobe of the liver
show a relatively echogenic,
solid hepatocellular carcinoma
ſt with a hypoechoic halo.
Background liver is
heterogeneous, indicating
cirrhosis.
Diagnoses: Liver
(Left) Transverse grayscale
and color Doppler US of the
main portal vein show a solid,
intraluminal tumor thrombus
with marked internal
vascularity ſt. Presence of
tumor thrombus almost
always indicates infiltrative or
extensive hepatocellular
carcinoma. (Right) Spectral
tracings of the vascular area in
the tumor thrombus (same
patient) show arterialized
waveforms directed away
from the liver, reflecting
arterial neovascularity that
feeds the tumor thrombus.
(Left) Contrast-enhanced CT in
late arterial phase (left) and
delayed phase (right) shows
infiltrative hepatocellular
carcinoma st in the right lobe
of the liver with tumor
thrombus in the portal vein
ſt. Underlying liver is
cirrhotic, and gastric varices
and moderate ascites are
evident. (Right) Transverse
grayscale US of the liver shows
a mixed echogenicity
hepatocellular carcinoma ſt.
Background liver is mildly
cirrhotic and ascites is
present.
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