PREOPERATIVE DETECTION OF METASTATIC HEPATIC TUMORS

In 21 patients with metastatic hepatic tumors undergoing hepatectomy, preoperative findings on ultra-sonography (US), computed tomography (CT), magnetic resonance imaging (MRI), and angiography (AG) of the liver were compared with those of macroscopic metastatic lesions in the resected specimenes. The most common primary tumors occurred in the colon (8), followed by rectum (7), and stomach (6). There were 56 macroscopic lesions in the resected specimens. The median number of the lesions was 3 (range, 2 to 16) in 9 patients with multiple metastasis. The median diameter of the lesions was 15.0mm (range, 1 to 130mm) in all patients. When tumors were smaller than 9mm, all examinations failed to depict the tumors. In tumors larger than 10mm and smaller than 19mm, sensitivity of MRI was 25%, whereas those of US, CT, and AG were 14.4%, 7.1%, and 15.4%, respectively. In tumors larger than 20mm, sensitivity of MRI was 100%, while those of US, CT, and AG were 90.0%, 86.4%, and 70.0%, respectively. Although MRI was superior to other examinations in preoperative detection of the lesions, all examinations showed surprisingly high false-negative results.