Imaging Characteristics of Focal Liver Lesions on Contrast-Enhanced Helical Computed Tomography
Introduction: The discovery of computed tomography (CT) by G.N. Hounsfield in 1972 has been a milestone in medical
diagnostic imaging as cross-sectional imaging took a step into diagnostic radiology. The use of contrast agents for CT of the
liver has been used since long back. However, the advent of multidetector helical CT has made the dream of multiphasic
imaging a reality. This has led to imaging the liver during the various phases of enhancement and helping in characterization
and detection of the lesions.
Material and methods: This prospective study was done in the Department of Radiodiagnosis and Imaging at Bhopal Medical
Centre, Bhopal, Madhya Pradesh, India. Atotal of 100 patients who were referred to our department with strong clinical suspicion
of focal liver lesion and those diagnosed by ultrasonography underwent multiphasic contrast-enhanced CT evaluation of abdomen
using single-slice spiral CT scanner from March 2010 to May 2012.
Results: In our study, the majority of cases diagnosed were that of malignant lesions in 47% of cases. The other lesions
diagnosed were benign lesions in 34% of cases and inflammatory lesions in 19% of cases. Among the malignant lesions, the
most common diagnosis was that of metastases seen in 67% of cases. The next most common was hepatocellular carcinoma
(HCC) seen in 29% of cases.
Discussion: Contrast-enhanced multiphasic CT plays an indispensable role in the detection and characterization of focal
lesions of the liver. The aspects of the identified liver abnormalities influence the clinical and surgical decision-making. Benign
abnormalities such as cysts and hemangioma do not require treatment, but some benign cases require treatment such as FNH
and hepatocellular adenoma requires treatment in some cases. Malignant lesions arising from the liver such as HCC often need
treatment. Metastases may or may not be amenable to treatment.
Conclusion: The accuracy of contrast-enhanced multiphasic CT in detecting and characterizing focal liver lesions is high, and
it should be considered in the imaging workup of any patient with focal liver lesions. This helps in guiding further management
of these patients avoiding unnecessary investigations and workup for the diagnosis as there is a high incidence of benign
pathologies in the liver.
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