Spiral CT of Hepatic Masses ; Usefulness of Additional Findings Except Enhancement Patterns

Korean J Hepatol > Volume 4(1); 1998 > Article

The Korean Journal of Hepatology 1998;4(1): 23-32.

원저 : 간종괴의 나선식 CT ; 조영증강양상이외의 부수적 소견의 유용성 ( Original Articles : Spiral CT of Hepatic Masses ; Usefulness of Additional Findings Except Enhancement Patterns )

Spiral CT of Hepatic Masses ; Usefulness of Additional Findings Except Enhancement Patterns

Keun Young Kong , Dong Ho Lee , Young Tae Ko , Ju Won Lim , Joung Il Lee , Byung Ho Kim

ABSTRACT

Backgound/Aims - We compared the accuracy in the diagnosis of hepatic masses such as hepatocellular carcinoma (HCC), metastasis and hemangioma using enhancing pattern alone with using additional findings, and determined whether the additional findings could improve the diagnostic accuracy. M ethods/Materials Triphasic spiral CT images were retro- spectively analyzed in 83 cases of hepatic lesions,' 40 HCC, 21 metastases, and 22 hemangiomas. Three observers made the diagnosis first by the enhancement pattern of the mass alone, and then, by the whole information. The diagnosis of a lesion was considered correct if the lesion was correctly categorized by at least two observers. Diagnostic accuracies of two sessions were compared with McNemar test. Results - Using enhancing patterns alone, 31/40 HCC (78%), 8/21 metastases (38%), 21/22 hemangiomas (95%) were correctly diagnosed. The frequency of correct diagnosis was significantly improved when all images with additional findings were used: 36/40 (90%) HCC, 20/21 (95%) metastases, 22/22 (100%) hemangiomas (P=0.00006). Metastasis showed most prominent and statistically significant improvement in the diagnostic accuracy (P=0.0004). The number of correct diagnoses for HCC increased without statistical significance (P=0.17). However, the images with additional findings did not significantly contribute to the diagnosis of hemangiomas. The additional finidngs those led to correct diagnosis of metastases were multiple mass (7 cases), coexistence of primary malignancy (6 cases), and metastasis to other organ (1 case). The findings of liver cirrhosis were helpful to diagnose HCC correctly in 5 cases. Conclusion- The enhancing pattems of tumors were important in the diagnosis of hepatic masses in spiral CT. However, the additional finidngs were also helpful for the diagnosis of hepatic masses especially for the masses with atypical enhancement pattern. In metastases, the additional findings such as multiple masses or detection of primary malignant focus were useful to diagnose correctly. (Korean J Hepatol 1998;8:23 - 32)

KeyWords: liver neoplasms , CT , helical technology