An introduction to bundles, connections, metrics and by Taubes C.H.

By Taubes C.H.

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26 A, B. Case i, CT scans, The arrow in A indicates mass B in Fig, 3,25, The arrow in B indicates mass A in Fig, 3,25 -liver--=: -===---- --=::'--- - ----~ ~ - d[aP/lragm Fig. 27. Case 2, There is a 12-mm hypoechoic mass in the anterosuperior aspect of the right lobe of the liver. There were several other smaller lesions in this case (not shown), Irregularity of the surface of the liver and splenomegaly (not shown) strongly suggested that this lesion was a hepatocellular carcinoma Fig. 28. Case 3, In the right lobe of the liver, there are two solid lesions of 2 and 3 cm next to each other.

Abdominal wall A • middle hepatic vein anterosuperior branch rl. 8 ~ gallbladder neck epatiC vein bile duct portal vein D C Inferior vena cava Fig. 8. Vascular structures as visualized in the region of the porta hepatis on intercostal scanning abdominal wall A L----------~ B c Fig. 9. Right and middle hepatic veins as visualized on subcostal scanning 48 Liver Ultrasonographic Appearance of Normal Vascular Anatomy of the Liver Fig. 10. The horizontal portion of the portal vein and the hepatic duct.

There is therefore no ultrasound beam in the shaded area, resulting in a type of acoustic shadowing. This is called refractive shadowing 54 Liver Hepatocellular Carcinoma Correlation between size and echo pattern is often seen in hepatocellular carcinoma. Small hepatocellular carcinomas, less than 2 em in size, are almost always visualized as hypoechoic lesions, whereas intermediate-sized tumors of 3~4 em often exhibit anechoic rims or a mosaic pattern. Relatively large tumors of 5 em or greater demonstrate mixed patterns with echogenic and anechoic areas.

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