EFFICACY OF ULTRASOUND ELASTOGRAPHY IN CHARACTERIZING FOCAL LIVER LESIONS WITH HISTOPATHOLOGIC CORRELATION

Dr.K.B. NAGARAJAN; Dr.E. MANIMEKALA; Dr.R. Ravi

Volume : IX, Issue : III, March - 2019

EFFICACY OF ULTRASOUND ELASTOGRAPHY IN CHARACTERIZING FOCAL LIVER LESIONS WITH HISTOPATHOLOGIC CORRELATION

Dr. K. B. Nagarajan, Dr. E. Manimekala, Dr. R. Ravi

Abstract :

Context: Elastography, or elasticity imaging, measures the natural tendency of tissue to resume its original size and shape after being subjected to a deforming force or stress [1,2,3]. Neoplastic and inflammatory diseases can change the tissue‘s composition/structure and thus parenchyma stiffness of an organ. The stiffness measurements can be considered as a method of assessing focal liver lesions and the differentiation of those that are malignant from those that are benign. Aim: The purpose of the study is to assess whether ultrasound elastography can be used to differentiate between benign and malignant focal liver lesions. Methods and Material: This prospective study was carried in Rajiv Gandhi Government General Hospital for a period of 1 year. Patients were screened as per inclusion and exclusion criteria. A total of 50 patients with focal liver lesions underwent abdominal sonographic examinations and free hand elastography using Hitachi Aloka Arietta S70 Machine. Elastographic parameters were measured for each focal hepatic lesion. The mean of the observed values was calculated for each group of lesions. These values were correlated with histopathological results. The ability of these values to differentiate between benign and malignant focal liver lesions was assessed. Statistical analysis used: The collected data were analysed with IBM.SPSS statistics software 23.0 Version. Results: There was highly significant difference between mean values of all four elastographic parameters (Stiffness value, Stiffness Ratio, Shear wave velocity & Strain Ratio) between malignant and benign liver lesions (P value ≤ 0.01). The mean values of elastographic parameters were significantly higher in malignant liver lesions compared to benign liver lesions. Strain Ratio was found to be a better parameter than the remaining three parameters helpful in differentiating between malignant and benign liver lesions with 100% sensitivity and 100% specificity. Conclusion: Our study showed the feasibility of ultrasound elastography, in discriminating between malignant and benign liver lesions, which can be an aid in further management.