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Imaging

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Imaging techniques that may be of value include:

  • plain abdominal x-ray - may demonstrate calcification within the liver (sunburst lesion)

  • plain chest x-ray - for metastases

  • abdominal ultrasound - tumour shown as a hypo-echoic shadow with ill-defined margins; lesions less than 2cm may be revealed

  • CT - tumour appears as a hypodense lesion which does not enhance with contrast. Detection may be improved by injecting the hepatic artery with lipiodol which is cleared only from non-cancerous tissue

  • MRI - may be more sensitive than CT, particularly if fatty liver co-exists

  • hepatic angiography - valuable in diagnosis, localisation and ascertainment of operability as the tumour is supplied by the hepatic artery

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