Journal of Gastrointestinal Surgery

, Volume 11, Issue 8, pp 970–976 | Cite as

Echogenic Appearance of Colorectal Liver Metastases on Intraoperative Ultrasonography is Associated with Survival After Hepatic Resection

  • Michelle L. DeOliveira
  • Timothy M. Pawlik
  • Ana L. Gleisner
  • Lia Assumpcaom
  • Gaspar J. Lopes-Filho
  • Michael A. Choti


Survival after resection of colorectal liver metastases has traditionally been associated with clinicopathologic factors. We sought to investigate whether echogenicity of colorectal liver metastasis as assessed by intraoperative ultrasound (IOUS) was a prognostic factor after hepatic resection. Prospective data on tumor IOUS appearance were collected in 84 patients who underwent hepatic resection for colorectal liver metastasis. Images were digitally recorded, blindly reviewed, and scored for echogenicity (hypo-, iso-, or hyperechoic). The median tumor number was 1 and the median tumor size was 5.0 cm. At the time of surgery, the IOUS appearance of the colorectal liver metastases were hypoechoic in 35 (41.7%) patients, isoechoic in 37 (44.0%) patients, and hyperechoic in 12 (14.3%) patients. Traditional clinicopathologic prognostic factors were similarly distributed among the three echogenicity groups (all p > 0.05). Patients with a hypoechoic lesion had a significantly shorter median survival (30.2 months) compared with patients who had either an isoechoic (53.2 months) or hyperechoic (42.3 months) lesion (p = 0.005). The 5-year survival after hepatic resection of colorectal liver metastasis was also associated with the echogenic appearance of the lesion (hypoechoic 14.4 vs isoechoic 37.4 vs hyperechoic 46.2%) (p < 0.05). Intraoperative ultrasound echogenicity should be considered a prognostic factor after hepatic resection of metastatic colorectal cancer.


Colorectal metastases Intraoperative ultrasound Echogenicity Prognosis 



Dr. Michelle L. DeOliveira (BEX 153204) and Dr. Ana L. Gleisner (BEX 1128/05-1) are supported by grants from the Coordenação de Aperfeiçoamento de Pessoal de Nivel Superior . Dr. DeOliveira and Dr. Pawlik contributed equally to the production of this manuscript.


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Copyright information

© The Society for Surgery of the Alimentary Tract 2007

Authors and Affiliations

  • Michelle L. DeOliveira
    • 1
  • Timothy M. Pawlik
    • 1
  • Ana L. Gleisner
    • 1
  • Lia Assumpcaom
    • 1
  • Gaspar J. Lopes-Filho
    • 1
  • Michael A. Choti
    • 1
  1. 1.Department of SurgeryThe Johns Hopkins University School of MedicineBaltimoreUSA

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