Role of Ultrasonography and Contrast Enhanced Ct in Detection of Focal Liver Lesions in a Rural South Indian Population

Abstract

BACKGROUND Focal liver lesions are frequently encountered by radiologists mostly during routine ultrasonography and then are usually evaluated further by contrast enhanced CT. Dedicated triple phase CT helps in studying the nature of the lesion by the timing and pattern of enhancement. For instance, metastasis shows early arterial enhancement and early washout in contrast to Haemangioma which shows delayed wash out following portal phase enhancement. This further narrows the diagnosis which can then be confirmed histopathologically in cases where biopsy is indicated. This study aims at understanding the aptness of USG as first line of imaging in detecting focal hepatic lesions and comparing the findings with CECT and histopathology. The objectives of the study were-1. To determine the diagnostic accuracy and role of ultrasonography in evaluation of focal liver lesions. 2. To compare the findings with contrast enhanced CT. 3. To compute sensitivity, specificity and accuracy of ultrasonography in detecting focal hepatic lesions. MATERIALS AND METHODS This prospective study spanned over three years. 106 patients who were detected sonographically with focal liver lesions were selected. Patient details including relevant clinical history were recorded. The sonographically detected lesions were subjected to contrast enhanced CT of abdomen, follow up USG and in few cases, with histopathology, to reach confirmatory diagnosis. RESULTS Of the 106 patients, incidence of focal liver lesions was found to be more in males in the ratio of 1.4: 1. Most patients were 41-50 years (24.5%) of age. Right lobe showed predominant involvement-2.9: 1 and both lobes were involved in 26% cases. Contrast enhanced CT was done in all cases and biopsy was done in 24 patients. USG was repeated in 18 cases. Ultrasonography showed: Sensitivity-93.9%, Specificity-98.5% Accuracy-98.4%