Utilization of Contrast-Enhanced Ultrasound in Diagnosis of Focal Liver Lesions.

IF 1.5 Q3 GASTROENTEROLOGY & HEPATOLOGY International Journal of Hepatology Pub Date : 2024-10-24 eCollection Date: 2024-01-01 DOI:10.1155/2024/3879328
Fady Salama, Nimish Thakral, Christina Delacruz Leyson, Venkata Konjeti, Karim Benrajab, Gregory Hawk, Harrison Fouch, Roberto Gedaly, Aman Khurana
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Abstract

Background and aims: Focal liver lesions (FLL) are one of the most common indications for hepatology and hepatobiliary surgery consultation. In this retrospective study, we aim to assess if contrast-enhanced ultrasound (CEUS) can address diagnostic dilemmas in the evaluation of indeterminate liver lesions by identifying characteristics of indeterminate FLL on CEUS and correlating these with cross-sectional imaging and pathology findings. Methods: We retrospectively reviewed all patients who underwent CEUS evaluation for liver lesions over a 28-month period (Oct 2020 to Jan 2023) at the University of Kentucky. To assess the relationship between CEUS results and the corresponding CT, MRI, and/or pathologic findings, the McNemar-Bowker tests were performed. Results: Twenty-nine patients were included (after two exclusions from a total n of 31). Mean age was 54 years, 62% were female, and 48% had underlying cirrhosis. Of the 29 patients with initial cross-sectional imaging, the initial results showed malignancy or likely malignant lesion in 6 patients and benign or likely benign lesion in 6 patients. The remaining 17 patients had inconclusive/indeterminate results. CEUS clarified an "indeterminate" CT/MRI result 15 times out of 17 (88.2%), moving the diagnosis to "benign" 11 times while suggesting "malignant" only four times. When aggregating indeterminate cross-sectional results with either benign or malignant categories suggested by CEUS, CEUS never reversed a benign CT/MRI diagnosis but often reversed a malignant CT/MRI diagnosis. Conclusion: CEUS provided a definitive diagnosis of indeterminate liver lesions in approximately 90% of patients and avoided the need for biopsy in most patients. In cases where the liver lesions were biopsied, CEUS accurately distinguished malignant versus benign lesions as confirmed by biopsy findings. CEUS, therefore, has the potential to provide a precise diagnosis for the majority of indeterminate lesions.

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利用对比增强超声波诊断肝脏病灶。
背景和目的:局灶性肝脏病变(FLL)是肝脏病学和肝胆外科会诊最常见的适应症之一。在这项回顾性研究中,我们旨在评估造影剂增强超声(CEUS)是否能通过确定 CEUS 上不确定 FLL 的特征并将这些特征与横断面成像和病理结果相关联,从而解决评估不确定肝脏病变时的诊断难题。方法:我们回顾性分析了肯塔基大学在 28 个月内(2020 年 10 月至 2023 年 1 月)接受 CEUS 评估肝脏病变的所有患者。为了评估 CEUS 结果与相应 CT、MRI 和/或病理结果之间的关系,我们进行了 McNemar-Bowker 检验。结果:共纳入 29 名患者(31 人中排除了 2 人)。平均年龄为 54 岁,62% 为女性,48% 有潜在肝硬化。在29名进行初步横断面成像的患者中,初步结果显示6名患者为恶性或可能为恶性病变,6名患者为良性或可能为良性病变。其余 17 名患者的结果为不确定/不确定。17例患者中有15例(88.2%)的CT/MRI结果为 "不确定",CEUS对其进行了澄清,11次将诊断结果改为 "良性",只有4次提示 "恶性"。当将不确定的横断面结果与 CEUS 建议的良性或恶性类别汇总时,CEUS 从未逆转良性 CT/MRI 诊断,但经常逆转恶性 CT/MRI 诊断。结论:CEUS为约90%的患者提供了不确定肝脏病变的明确诊断,避免了对大多数患者进行活组织检查。在对肝脏病变进行活检的病例中,CEUS能准确区分恶性和良性病变,活检结果也证实了这一点。因此,CEUS有可能为大多数不确定的病变提供精确诊断。
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来源期刊
International Journal of Hepatology
International Journal of Hepatology GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
3.80
自引率
0.00%
发文量
11
审稿时长
15 weeks
期刊介绍: International Journal of Hepatology is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies related to the medical, surgical, pathological, biochemical, and physiological aspects of hepatology, as well as the management of disorders affecting the liver, gallbladder, biliary tree, and pancreas.
期刊最新文献
Utilization of Contrast-Enhanced Ultrasound in Diagnosis of Focal Liver Lesions. Anatomical Variations of the Gallbladder and Bile Ducts: An MRI Study. The Role of Gut Microbiota Modification in Nonalcoholic Fatty Liver Disease Treatment Strategies. Evaluation of Noninvasive Tools for Predicting Esophageal Varices in Patients With Cirrhosis at Tygerberg Hospital, Cape Town. Impact of Renal Replacement Therapy on Outcomes of Living Donor Liver Transplantation for Acute Liver Failure: A Cohort Study.
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