Is ultrasound elastography adding value in diagnosis of focal hepatic lesions? Our experience in a single-center study

Abstract

Abstract Background The aim of this study was to assess the use of ultrasound elastography in differentiating hepatic lesions in order to increase the sensitivity and specificity of grey-scale ultrasound. Methods This study included 104 patients who were referred to the radiology department at Alexandria Main University Hospital for focal hepatic lesions detected by grey-scale ultrasound and were recommended to undergo further evaluation by ultrasound elastography. All studied patients were subjected to the following: (1) grey-scale ultrasound and ultrasound elastography using semiquantitative technique and (2) triphasic MDCT of the liver. MRI was done in 11 patients with malignant lesions; further confirmation with histopathological assessment was conducted. Results Benign lesions showed a low strain ratio, while malignant lesions showed a high strain ratio. The mean ratio in the benign lesions was 1.08 ± 0.40, while the mean ratio in the malignant lesions was 4.14 ± 1.25. The cut-off value used to diagnose the malignant lesions and differentiate these lesions from the benign lesions was 1.7, which had a sensitivity of 100%, specificity of 93.10%, PPV of 97.40% and NPV of 100%. Conclusion Ultrasound elastography is a promising non-invasive, non-contrast technique that can be added to routine grey-scale sonographic examinations of the liver to characterize hepatic lesions.

Keywords

• Ultrasound, Elastography, Focal hepatic lesions, Stiffness, Strain ratio