Sonographic diagnosis of liver and pancreatic tumors

From an overall point of view sonographic diagnostics of tumours of the liver is characterised by a high degree of sensitivity. Although an approximate differentiation between benign and malignant tumours is possible, it is not sufficiently reliable. Compared with the often monotonous CT imaging of liver tumours, the extremely "colourful" sonographic image (which seems to be full of "variety of species") of lesions of the liver supplies decisive pointers, so that the range of tumours to be considered in differential diagnosis becomes more limited. Such preselection is important especially for the choice of further measures to confirm the diagnosis. Sonographic differentiation between primary and secondary liver tumours is uncertain, and hence histological verification is mandatory. In what way sonography can help to determine whether a tumour is operable or not, has not yet been studied and is therefore by no means clear. Sonography is highly sensitive in the detection of tumours of the pancreas, especially with minor lesions of less than 2 cm diameter. The sonographic image of the adenocarcinoma is non-specific, so that it must be considered imperative to clarify by histological examination even extensive findings that appear totally inoperable, so that a distinction can be made against tumours of the pancreas which have a better prognosis. Sonographic assessment of whether or not a tumour can be resected can only be effected in a negative sense if there are unequivocal sonographic criteria proving that the tumour is inoperable.