Imaging Accuracy in Diagnosis of Different Focal Liver Lesions: A Retrospective Study in North of Iran.

INTRODUCTION: Focal liver lesions (FLLs) are incidentally detected masses found in daily abdominal imaging which are necessary to be characterized, because of the potential of being malignant. There are several imaging methods, such as ultrasonography (US), computed tomography (CT scan), and contrast enhanced magnetic resonance imaging (MRI). Here, we evaluate and compare the diagnostic accuracy (i.e., sensitivity and specificity) of these imaging methods for the diagnosis of FLLs. MATERIAL AND METHODS: In this retrospective study, patients with focal liver lesions included and based on the gastroenterologist decision, in 79 patients different imaging methods were used to determine the nature of FLLs: the US, CT scan, and MRI. At the next step, fine-needle aspiration biopsy (FNA) was performed in all cases, and the results about the true nature of FLLs compared with different imaging results. The chi-square test and McNemar test were used. RESULTS: Ultrasound diagnosis of benign and malignant was obtained with 82% diagnosis accuracy, 100% sensitivity, 71.4% specificity, 100% negative predictive value, and 69.2% positive predictive value (PPV) compared with the biopsy. Also, the results of benign and malignant masses in CT scan were obtained with diagnostic accuracy of 95%, 100% sensitivity, 80% specificity, 93.9% positive predictive value, and 100% negative predictive value. MRI performed only in 2 cases with similar results to pathology. CONCLUSION: It seems that CT scan is more appropriate and useful in the diagnosis of hepatic masses due to its higher diagnostic accuracy than the ultrasound.

Gallstone disease founded by ultrasonography in functional dyspepsia: prevalence and associated factors.

The aim of this study was to evaluate the frequency of gallbladder stone in functional dyspepsia (FD) by abdominal ultrasonography and to determine the factors associated with this frequency in Guilan province. A total of 195 subjects who referred to outpatient clinic of Razi Hospital, a tertiary referral center (Guilan, Iran) to evaluate FD were included in this study. They were interviewed by using a questionnaire and underwent ultrasonography. Among the 195 subjects were 18.5% male and 81.5% female. The overall frequency of Gallstones (GS) was 19% (37/195) with 17% males and 83% female. In patients with dyspepsia, the presence of fatty liver evidenced by ultrasonography was 67% (131/195). From 131 patients with fatty liver disease 24 (18.3%) have been reported GS. The most frequent symptom in all participants as well as patients with GS and patients with fatty liver was abdominal pain (69.7%, 81% and 66%, respectively) followed by excess flatus. Risk factor associated with increased odds ratios (ORs) for the development of gall stones was diabetes mellitus (OR = 2.63). It also showed that gallbladder wall thickening was more common in patients with GS (OR = 36.63). GS disease was not significantly related to the age, gender, fatty liver, renal stone, history of hypertension (HTN) and hyperlipidemia (HLP), alcohol consumption and smoking status. Patients with FD especially if they have diabetes should be referred for upper abdominal ultrasonography for screening and early detection of GS disease.