ABSTRACT
A reliable affirmation and delineation of focal liver injuries is crucial for immaculate patient association. The commonly encountered liver masses on ultrasonography are simple liver cyst, haemangioma, metastasis, hepatocellular carcinoma etc. We wanted to assess the accurate detection and characterization of liver masses among patients with liver lesions. METHODSA prospective study was conducted among 60 patients with liver lesions, who had undergone both abdominal ultrasonography and computed tomography and correlation was done with histopathology (FNAC / FNAB) for confirmation. Ultrasonography of liver imaging was obtained with SIEMENS and Longitudinal (sagittal), transverse (horizontal), coronal and oblique planes were obtained by using 3.5 MHz frequency transducer. Triple-phase helical CT images of the liver were obtained with Siemens Emotion 16 slice MDCT machine with 5 mm collimation, 0.6 mm reconstruction interval, gantry rotation speed of 0.6 second, pitch of 1.375:1, 120 kV, and 600 mA. RESULTSLesions which were encountered in the given time span were hepatocellular carcinoma (20 %), metastasis (33.3 %), hydrated cyst (2 %), abscess (5 %), haemangioma (13.3 %), Gb carcinoma, cholangiocarcinoma and other (5 % each) and simple liver cysts (10 %). Among the metastases observed in the liver, 20 % cases were from colorectal malignancies, 20 % were from lung, 15 % from breast, 15 % from ovary, and 15 % were from oesophagus and 15 % were from stomach. The highest percentages of liver metastases were from colon and rectum followed by lungs, oesophagus and stomach, and breast and ovary. Our study showed an accuracy of 98 % in diagnosing various lesions by confirming these diagnoses using image guided FNAC / FNAB. CONCLUSIONSClinical diagnosis based on examination can be very inaccurate, radiological investigations using ultrasonography and computed tomography can help us to arrive at an accurate diagnosis most of the times. Image guided FNAC / FNAB can confirm / dispute radiological diagnosis. This shows excellent correlation between radiological diagnosis and histological diagnosis of various liver lesions.
ABSTRACT
BACKGROUND/AIMS: To evaluate the diagnostic value of contrast (SonoVue(R)) enhancement ultrasonography (CEUS) and to compare this method with computed tomography (CT) and magnetic resonance imaging (MRI) in evaluating liver masses. METHODS: CEUS (n=50), CT (n=47), and MRI (n=43) were performed on 50 liver masses in 48 patients for baseline mass characterization. The most likely impression for each modality and the final diagnosis, based on the combined biopsy results (n=14), angiography findings (n=36), and clinical course, were determined. The diagnostic value of CEUS was compared to those of CT and MRI. RESULTS: The final diagnosis of the masses was hepatocellular carcinoma (n=43), hemangioma (n=3), benign adenoma (n=2), eosinophilic abscess (n=1), and liver metastasis (n=1). The overall diagnostic agreement with the final diagnosis was substantial for CEUS, CT, and MRI, with kappa values of 0.621, 0.763, and 0.784, respectively. The sensitivity, specificity, and accuracy were 83.3%, 87.5%, and 84.0%, respectively, for CEUS; 95.0%, 87.5%, and 93.8%, respectively, for CT; and 94.6%, 83.3%, and 93.0%, respectively for MRI. After excluding the lesions with poor acoustic sonographic windows, the sensitivity, specificity, and accuracy for CEUS were 94.6%, 87.5%, and 93.3%, respectively, with a kappa value of 0.765. CONCLUSIONS: If an appropriate acoustic window is available, CEUS is comparable to CT and MRI for the diagnosis of liver masses.