MetResect
An educational tool to assist in the management of hepatic metastases in patients with colorectal cancer.

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Case 36: RADIOLOGIC ASSESSMENT

      Film Review  

Discussant: FERGUS COAKLEY, MD (Dr Alberts Case)

Images:

Here are four images from a contrast-enhanced CT scan that were obtained in the portal venous phase. We can see that both the liver parenchyma and the portal veins are opacified, and at least four suspicious lesions are present.

In this image we see an approximate 2-cm solid-appearing lesion in the left lobe, in line with the left hepatic vein.

Case 36

 

Moving to the next image, a similar lesion appears to be tucked in between the cava and the right hepatic vein, probably at the junction of segment VI and VII because we’re right at the level of the porta hepatis.

Case 36

 

Moving to the next image, another similar lesion is present in the periphery of the right lobe, at the junction of segments V, VI, VII and VIII — it’s right at the point where those sections meet at the level of the porta hepatis and midway between the front and back of the right lobe.

Case 36

 

The final image shows two lesions on a more inferior level. I’m not sure how to count those with that other lesion above it — whether to count them as a cluster of lesions or several separate lesions — but clearly all of these lesions are suspicious.

Case 36

 

 

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