Moderne diagnostik fokaler leberlasionen: Methoden, indikationen und befundmuster

Focal liver lesions are most frequently detected on the occasion of an ultrasound examination or during staging of patients suffering from tumours. Especially in patients with tumours, the differentiation between benign and malignant hepatic lesions has a decisive influence on further treatment. Preoperatively, it is important for the surgeon to know whether a lesion is a solitary and resectable one. For screening ultrasonography remains the method of first choice. However, is the characterisation of a lesion rarely securely possible employing ultrasonography, therefore CT and MRI are applied as further means of investigation. The introduction of spiral CT and the use of fast MRI sequences, as well as the development of specific hepatic contrast media further improved the sensitivity and specificity of modern slice imaging. Preoperative CTAP, so far considered to be the gold standard, does not show any advantages over contrast-enhanced MRI, therefore it has to be expected that MRI is going to replace CTAP, as well as due to less invasiveness as for socio-economic reasons.