Anatomical variation of the liver with elongated left lobe may be a trap forthe ultrasound detection of focal liver lesion.

Abstract

Aims: The aim of this study was to evaluate the impact of anatomical variations of the elongated left lobe of the liver on the ultrasound detection of focal liver lesions. Materials and methods: We evaluated, by ultrasonography (US), 296 patients with elongated left lobe of the liver and 30 patients with focal lesions in the normal length left lobe of the liver. Those patients had undergone prior computed tomography (CT) evaluation. Results: Of the 296 patients evaluated, 34 patients had focal lesions (the size range 11- 20 mm) in the distal region of the elongated left lobe of the liver, and none of the lesions was visualized at US examination (p<0.001). All the focal lesions in the normal length left lobe of the liver of the 30 patients were visualized by US without significant difference between the dimensions established by CT and US (p=0.136). Conclusion: Focal lesions in the distal region of elongated left lobe of the liver are difficult to be detected by conventional US examination and the main reason is the impact of anatomical localization on the examination protocol.