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Ultrasonography of liver tumors involves two stages: detection and characterization.
Tumor detection is based on the performance of the method and should include morphometric information and topographic information. The specification of these data is important for staging liver tumors and prognosis.
Tumor characterization is a complex process based on a sum of criteria leading towards tumor nature definition. Often, other diagnostic procedures, especially interventional ones are no longer necessary. Tumor characterization using the ultrasound method will be based on the following elements: consistency , echogenicity, structure appearance , delineation from adjacent liver parenchyma , elasticity, posterior acoustic enhancementeffect, the relation with neighboring organs or structures , vasculature.
The substrate on which the tumor condition develops andthe developing context are also added. Particular attention should be paidto the analysis of the circulatory bed. Microcirculation investigation allows for discrimination between benign and malignant tumors. Characteristic elements of malignantcirculation are vascular density, presence of vessels with irregular paths and size, some ofthem intercommunicating, some others blocked in the end with "glove finger" appearance,the presence of arterio-arterial and arterio-venous shunts, lack or incompetence of arterialprecapillary sphincter made up of smooth musculatures.Diagnosis and characterization of liver tumors require a distinct approach for each group ofconditions, using the available procedures discussed above for each of them. The correlationwith the medical history, the patient's clinical and functional status are important elements that should also be considered.