Modern diagnostic of focal hepatic lesions: Methods, indications and finding-patterns

Focal liver lesions are most frequently detected on the occasion of an ultr asound examination or during staging of patients suffering from tumours. Es pecially in patients with tumours, the differentiation between benign and m alignant hepatic lesions has a decisive influence on further treatment. Pre operatively, it is important for the surgeon to know whether a lesion is a solitary and resectable one. For screening ultrasonography remains the meth od of first choice. However, is the characterisation of a lesion rarely sec urety possible employing ultrasonography, therefore CT and MRI are applied as further means of investigation. The introduction of spiral CT and the us e of fast MRI sequences, as well as the development of specific hepatic con trast media further improved the sensitivity and specificity of modern slic e imaging. Preoperative CTAP, so far considered to be the gold standard, do es not show any advantages over contrast-enhanced MRI, therefore it has to be expected that MRI is going to replace CTAP, as well as due to less invas iveness as for socio-economic reasons.