Differential Diagnosis of Focal Hepatic Lesions Using Ultrasound Confirmed with Histopathology: Recent Advancement

R. Ahmed, S. Alkathiri, Waad Altalhi, Hatun Eid, Manar Alshalawi, Sara Alotaibi
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Abstract

Advances in imaging technology over the past decades have contributed to better characterization of hepatic lesions. This study aims to differentiate focal hepatic lesions from their ultrasound (U/S) features and compared the obtained results with histopathology. A descriptive retrospective study of 100 patients who had focal hepatic lesions were reviewed during the period from 2012 to 2019 at King Abdul-Aziz Specialist Hospital, Taif, KSA. The inclusion criteria were Adults Saudi patients, ages 18 and above. LG-9 and Philips ultrasound machines with 3.5 MHz transducers were used in this study. Age group (55 to 80 years) represented 44%, mean age was 49 years, 92% were married. Regarding shape of the lesions during U/S scan, 47% of irregular outline were malignant (p=0.00), 93% of the rounded lesions were benign (p=0.00),86% of well-defined lesions margins were benign in histopathology, 61% ill-defined margin lesions were malignant and 73% of hyperechoic lesions were hemangioma (p=0.02). Regarding nature of hepatic lesions during U/S, 87% of solid lesions were malignant (p=0.03), while 89% of cystic lesions were benign. 61% of hypoechoic lesions were malignant. 80% from vascular lesions under color Doppler were benign. U/S sensitivity and specificity were 93.5 and 98%, respectively. U/S is a useful tool in differentiation cystic hepatic lesions from solid (p=0.03). Comparable studies with large samples must be done in Taif region to provide data base for hepatic lesions. Most of selected hepatic lesions with suspicious features were confirmed as malignant in histopathology with high degree of sensitivity and specificity.
肝局灶性病变的超声鉴别诊断与病理组织学:最新进展
在过去的几十年里,成像技术的进步有助于更好地表征肝脏病变。本研究旨在区分局灶性肝脏病变的超声特征,并将所获得的结果与组织病理学进行比较。对2012年至2019年在沙特塔伊夫阿卜杜勒-阿齐兹国王专科医院进行的100例局灶性肝脏病变患者的描述性回顾性研究进行了回顾。纳入标准为18岁及以上的成年沙特患者。本研究使用LG-9和Philips的3.5 MHz换能器超声机。年龄层(55 - 80岁)占44%,平均年龄49岁,92%已婚。在U/S扫描中,47%的不规则轮廓为恶性(p=0.00), 93%的圆形病变为良性(p=0.00),86%的边界清晰的病变为良性,61%的边界不清的病变为恶性,73%的高回声病变为血管瘤(p=0.02)。对于U/S期间肝脏病变的性质,87%的实性病变为恶性(p=0.03), 89%的囊性病变为良性。61%的低回声病变为恶性。彩色多普勒检查血管病变80%为良性。U/S敏感性和特异性分别为93.5%和98%。U/S是区分囊性肝病变与实性肝病变的有效工具(p=0.03)。必须在Taif地区进行大样本的可比研究,为肝脏病变提供数据基础。所选择的可疑肝脏病变在组织病理学上大多被证实为恶性,具有高度的敏感性和特异性。
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