Role of Computerized Tomographic Findings in Cases of Focal Hepatic Lesions

Jump To References Section

Authors

  • Associate Professor, Department of Radiodiagnosis, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Adgaon, Nashik − 422003, Maharashtra ,IN
  • P.G. Resident, Department of Radiodiagnosis, Dr. Vasantrao Pawar Medical College and Hospital, Adgaon, Nashik − 422003, Maharashtra ,IN
  • Assistant Professor, Department of Radiodiagnosis, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Adgaon, Nashik − 422207, Maharashtra ,IN
  • P.G. Resident, Department of Radiodiagnosis, Dr Vasantrao Pawar Medical College, Hospital and Research Centre, Adgaon, Nashik − 422003, Maharashtra ,IN

DOI:

https://doi.org/10.18311/mvpjms/2019/v6i2/18662

Keywords:

Benign, Computerized Tomography, Hepatic, Lesion, Malignant, Tumour
Focal Hepatic

Abstract

Introduction: Focal Hepatic Lesions (FHL) has been a common reason for consultation faced by medical consultants. With the widespread use of imaging studies led to an increase in detection of incidental focal liver lesions. It is important to consider both malignant liver lesions as well as benign solid and cystic liver lesions such as hemangioma, focal nodular hyperplasia, hepatocellular adenoma, and hepatic cysts, in the differential diagnosis. Objectives: Our aim was to study the computerized tomographic finding in the various focal hepatic lesions and also to study the various enhancement pattern of the focal hepatic lesion. Materials and Methods: CT scan study of abdomen and pelvis was done on 100 patients from August 2015 to December 2017 over a period of the 2 years. Patients, irrespective of age and sex referred to radiology department of our institute on IPD or OPD basis were included in the study. All patients will be subjected to computerized tomography of the abdomen with CT (Siemens Somatom Emotion 6) machine and Somatom Essenza. Results: Total 100 patients were studied for various focal hepatic lesions out of which 64(64%) were male patients and 36(36%) were female patients. The most common affected age group encountered in our study was 51-60 years. Various focal hepatic lesions were reported in which 64(64%) patient had malignant nature of lesion with most common pathology detected was hepatic metastasis seen in 37(37%) patient. On other hand benign lesion were evident in the 36(36%) patient with hemangioma as most common pathology in this category. Conclusion: Multi-detector Computed Tomography (MDCT) with a correlation of triple phase study is an excellent tool for diagnosis of the focal liver lesion by learning the degree and pattern of enhancement in all three phase thus helping in better characterization of the lesion. MDCT allows the reconstruction and reformation of images supported in detecting multiple lesions and early diagnosis of a focal lesion in the presence diffuse liver condition.

Downloads

Published

2020-05-07

Issue

Section

Original Research Article

 

References

Marrero JA, Ahn J, Reddy KR, The on behalf of. ACG clinical guideline: The diagnosis and management of focal liver lesions. The American Journal of Gastroenterology. 2014; 109(9):132847. https://doi.org/10.1038/ajg.2014.213. PMid: 25135008.

Sutton D. Textbook of Radiology and Imaging. 7th Editio. Elsevier; 2003. p. 737.

van Leeuwen MS, Noordzij J, Feldberg MA, Hennipman AH, Doornewaard H. Focal liver lesions: Characterization with triphasic spiral CT. Radiology. 1996; 201(2):327-36. https://doi.org/10.1148/radiology.201.2.8888219. PMid:8888219.

Ahirwar CP, Patil A, Soni N. Role of triple phase computed tomography findings for evaluation of hepatic lesions. International Journal of Research in Medical Sciences. 2016; 4(8):3576-83. https://doi.org/10.18203/2320-6012.ijrms20162332.

Rajesh R, Rajesh K, Sayal C. Role of ultrasound and CT scan in evaluating focal liver lesions. Journal of Evolution of Medical and Dental Sciences. 2015; 4(104):16951-53.

https://doi.org/10.14260/jemds/2015/2556.

Elbarbary AA, Saleh HM, Elahwal EME. Role of diffusion weighted magnetic resonance imaging in evaluation of hepatic focal lesions. The Egyptian Journal of Radiology and Nuclear Medicine. 2015;46(2):325-34. https://doi.org/10.1016/j.ejrnm.2014.12.006.

Hafeez S, Alam MS, Sajjad Z, Khan ZA, Akhter W, Mubarak F. Triphasic Computed Tomography (CT) scan in focal tumoral liver lesions. Journal of the Pakistan Medical Association. 2011; 61(6):571-75.

Mohamed N, Hasan A, Zaki KF, Alam-eldeen MH. Benign versus malignant focal liver lesions: Diagnostic value of qualitative and quantitative diffusion weighted MR imaging. The Egyptian Journal of Radiology and Nuclear Medicine. 2016; 47(4):1211-20. https://doi.org/10.1016/j.ejrnm.2016.08.009.

Anaye A, Perrenoud G, Rognin N, Arditi M, Mercier L, Frinking P, Ruffieux C, Peetrons P, Meuli R MJ.

Differentiation of focal liver lesions: usefulness of parametric imaging with contrast-enhanced US.

Radiology. 2011; 261(1):300-10. https://doi.org/10.1148/radiol.11101866. PMid: 21746815.

Goel S, Chowdhury V, Singh S, Puri AS, Sakuja P. Role of acoustic radiation force impulse elastography and triphasic computed tomography in the evaluation of focal liver lesions. Tropical Gastroenterology. 2017; 37(3):191202. https://doi.org/10.7869/tg.353. PMid:30234944.

Nijalingappa, Naveen S, Maralahalli. Role of Diffusion Weighted Magnetic Resonance Imaging in Focal Liver Lesions. IOSR Journal of Dental and Medical Sciences Ver I [Internet]. 2015;14(7):2279-861. Available from: www.iosrjournals.org.

Nino-Murcia M, Olcott EW, Jeffrey RB, Robert LL, Beaulieu CF, Jain KA. Focal liver lesions: Patternbased classification scheme for enhancement at arterial phase CT. Radiology. 2000; 215(3):746-51. https://doi.org/10.1148/radiology.215.3.r00jn03746. PMid: 10831693.

Adam Y, Huevos A, Fortner J. Giant hemangioma of liver. Ann. Surg. 1970; 170:230-45. https://doi.org/10.1097/00000658197008000-00010. PMid: 433290, PMCid: PMC1397054.

Parikh T, Drew SJ, Lee VS, Wong S, Hecht EM, Babb JS, Taouli B. Focal liver lesion detection and characterization with diffusion-weighted MR imaging: Comparison with standard breath-hold T2-weighted imaging. Radiology. 2008; 246(3):812-22. https://doi.org/10.1148/ radiol.2463070432. PMid: 18223123.

Glazer GM, Aisen AM, Francis IR, Gross BH, Gyves JW, Ensminger WD. Evaluation of focal hepatic masses: A comparative study of MRI and CT. Abdominal Imaging. 1986; 11(1):263-68. https://doi.org/10.1007/BF02035086. PMid: 3743948.

Baron RL, Oliver Iii JH, Dodd Iii GD, Nalesnik M, Holbert BL, Carr B. Hepatocellular Carcinoma: Evaluation with biphasic, contrast-enhanced, helical CT' index terms: Computed tomography. Radiology. 1996; 199:505-11. https://doi.org/10.1148/radiology.199.2.8668803. PMid: 8668803.

Hwang J, Yoo S. Detection with Arterial, Carcinomas : At Spiral. 1997; 383-88. https://doi.org/10.1148/ radiology.202.2.9015062. PMid: 9015062.

Soyer P, Poccard M, Boudiaf M, Abitbol M, Hamzi L, Panis Y, Valleur P, Rolland R. Detection of hypovascular hepatic metastases at triple-phase helical CT: Sensitivity of phases and comparison with surgical and histopathologic findings. Radiology. 2004; 231(May 2):413-20. https://doi.org/10.1148/radiol.2312021639. PMid: 15044747.

Leslie DF, Johnson CD, Johnson CM, Ilstrup DM, Harmsen WS. Distinction between cavernous hemangiomas of the liver and hepatic metastases on CT: Value of contrast enhancement patterns. American Journal of Roentgenology. 1995; 164(3):625-29. https://doi.org/10.2214/ajr.164.3.786 3883. PMid: 7863883.

Yamashita Y, Ogata I, Urata J, Takahashi M. Cavernous hemangioma of the liver: Pathologic correlation with dynamic CT findings. Radiology. 1997; 203(1):121-25. https://doi.org/10.1148/radiology.203.1.9122378. PMid: 9122378.

Mangukiya DO, Darshan JR, Kanani VK, Gupta ST. A Prospective series case study of pyogenic liver abscess: Recent trands in etiology and management. Indian Journal of Surgery. 2012; 74(5):385-90. https://doi.org/10.1007/s12262-011-0397-0. PMid: 24082591, PMCid: PMC3477416.

Kayal A, Hussain A, Kayal A, Hussain A. A comprehensive prospectiveclinicalstudyofhydatiddisease. ISRNGastroenterology. 2014; 2014(March). https://doi.org/10.1155/2014/514757. PMid: 24734188, PMCid: PMC3966475.

Rao SS, Mehra B, Narang R. The spectrum of hydatid disease in rural central India: An 11-year experience. Annals of Tropical Medicine and Public Health. 2012; 5(3):225. https://doi.org/10.4103/1755-6783.98624.

Honda H. Intrahepatic peripheral cholangiocarcinoma: Two-phase dynamic incremental CT and pathologic correlation. J. Comput. Assist. Tomogr. 1993; 17:729-33.

https://doi.org/10.1097/00004728-199305000-00011.

Zhang Y, Uchida M, Abe T, Nishimura H, Hayabuchi N, Nakashima Y. Intrahepatic peripheral cholangiocarcinoma: Comparison of dynamic CT and dynamic MRI. Journal of Computer Assisted Tomography. 1999; 23(5):670-77. https://doi.org/10.1097/00004728-199909000-00004. PMid:10524843.

Zhou HB, Wang H, Zhou DX, Wang H, Wang Q, Zou SS, et al. Etiological and clinicopathologic characteristics of intrahepatic cholangiocarcinoma in young patients. World Journal of Gastroenterology. 2010; 16(7):881-85.

Klein WM, Molmenti EP, Colombani PM, Grover DS, Schwarz KB, Boitnott J, et al. Primary liver carcinoma arising in people younger than 30 years. Am. J. Clin. Pathol. 2005; 124(4):512-18. https://doi.org/10.1309/TT0R7KAL32228E99. PMid:16146811.

Valls C, Guma A, Puig I, Sanchez A, Andia E, Serrano T, Figueras J. Intrahepatic peripheral cholangiocarcinoma: CT evaluation. Abdominal Imaging. 2000; 25(5):490-96.

https://doi.org/10.1007/s002610000079. PMid:10931983.