ABSTRACT
A fter lymph nodes the liver is the most frequent site of metastatic spread of tumors and the commonest site of blood borne metastases. The presence of liver metastases alters the management of most patients with malignant disease and is probably the
most frequent indication for liver MR. In patients presenting with clinical or biochemical evidence of liver disease, sonography is usually the first imaging investigation. CT is recommended in patients with unexpected or equivocal sonographic findings, and is also used for baseline staging and surveillance in patients with malignant disease. MRI is reserved for lesion characterization in patients with indeterminate lesions found on surveillance sonography or CT following treatment of a primary tumor, and also assessing the suitability of patients for hepatic resection. Accurate preoperative staging is essential to avoid fruitless surgery in patients with unresectable disease. The main objectives of MRI in this context are the detection and localization of all metastases, the correct characterization of co-existing benign lesions, and the demonstration of the anatomic relation of tumors to the main hepatic vessels.
