Role of MDCT in Detection and Characterisation of Focal Liver Lesions
Dr. Shreshtha Jain,
ERAâ€™S Lucknow Medical College, Lucknow-226003, Uttar Pradesh, India.
Introduction: Multiphasic Computed Tomography (CT) has become the primary imaging modality for detection and characterisation of focal liver lesions. CT has assumed primary role in evaluating hepatic masses.
Aim: To assess the imaging features of focal liver lesions on Multidetector Computed Tomography (MDCT) and its comparative evaluation with histopathological results.
Materials and Methods: This cross-sectional study was conducted in the Department of Radiodiagnosis in a tertiary care hospital for a period of 18 months. Adult patients of age group 20-60 years with focal hepatic lesions on abdominal imaging (USG), all patients presenting with deranged liver function or known cases of liver mass lesions were included in the study and Quadriphasic Contrast Enhanced Computed Tomography (CECT) scan was done for them followed by biopsy. All the values for the arterial phase, venous phase, portal phase and delayed phase were recorded and analysed along with the histopathological and biochemical analysis report.
Results: As detected by MDCT, out of 84 focal liver lesions, benign focal liver lesions were 72(85.7%) and malignant lesions were 12 (14.3%). The diagnostic accuracy (efficiency) of MDCT was found to be 90.5% with predicted value (95% CI: 84.20-96.75%). For the hepatocellular carcinoma cases, highly significant agreement (p<0.001) was found between MDCT and biopsy techniques. The overall sensitivity, specificity, PPV, NPV and diagnostic accuracy for malignant lesions was found to be 83.3%, 97.2%, 83.3%, 97.2% and 95.2% respectively.
Conclusion: This study indicates MDCT to be highly sensitive in classifying the hepatic lesions into clinically relevant categories, making diagnosis and evaluation of lesion. It opens up new possibilities of early detection of liver lesions and its management.