Imaging and Pathologic Features of the Common Hepatic Focal Lesions

Background and Study Aims: Focal liver lesions are considerably detected in every day practice. Radiological imaging has a significant role in the detection and follow up of hepatic focal lesions. At times, the pathological study is absolutely necessary to confirm a definite diagnosis. The aim of this study was to estimate the probability that radiological scans to diagnose different types of focal liver lesions as primary imaging modalities are inconclusive.

Methods: This study was carried out at National Hepatology and Tropical Medicine Research Institute, Egypt. Abdominal ultrasonography, triphasic computed tomography +/- magnetic resonant imaging and ultrasound guided percutaneos core biopsy of 42 patients with suspected hepatic focal lesions were carried out.

Results: Out of 42 patients with liver focal lesions detected by transabdominal ultrasound and with inconclusive criteria by triphasic computed tomography +/- magnetic resonant imaging then confirmed by pathological examination, 8 were regeneration nodules, 18 hepatocellular carcinoma (HCC), 6 adenomas, 5 haemangiomas, 1 undifferentiated carcinoma,1 sarcoma., 2 abscesses and 1 dysplastic nodule.

Conclusions: Ultrasound is a safe and rapid method of detecting hepatic focal lesions, also allowed ultrasound guided interventions. High proportions of inconclusive criteria by additional scans were observed in this study. In this case histopathology is recommended to confirm the diagnosis.