Enhancement Pattern of liver Lesions:AComputerized Tomography Based Study

Abstract

The Objectives of this study wereto evaluate the enhancement pattern of liver lesions in the triphasic spiral computerized tomography (CT), as well as to validate the most suitable protocol for lesion detection correlated with the final CT opinion/diagnosis, in addition to find textural changes of liver and spleen, highlighting the most common associated findingsin those cases.A sample of 100 patients was used, their ages were from (24 – 88) years old, both genders were included. All were diagnosed to have liver lesions. This study was conducted in Radiology Department Wad MedaniHospital and ELsoni Clinic Center- WadMedani-Sudan, during the period from January 2015 up to January 2018.The sample included 26 cases of simple cyst ,2 with both cysts and abcess,19 of heamangioma,27hepatocelluler carcinoma(HCC )and 26 with metastases. Results showed that the most common liver enhancement pattern was heterogeneous in the hepatic arterial phase and in the portal venous phase. This finding was seen in 23% and 19% of lesions including (HCC) and metastases causing the liver texture to be heterogeneous. Other patterns of enhancement were not common sending-off homogeneous pattern in the cases of the cysts 21% and heamangioma 15%.The mean attenuation measurement of the cysts in the hepatic arterial phase was 35HU±69.98, and it increased in the portal venous phase to a mean of 39.92HU±72.40.Cysts and abscess showed HUof -705.00±134.35 in the arterial phase then showed an increasing at the venous phase to be -550.00±70.71 then reduced at the equilibrium phase to be-805.00HU±134.35.Haemangiomas was 44.42HU ±17.38in the arterial phase and increased in the venous phase 48.19HU±25.73 then decreased in the equilibrium phase 47.27HU±22.78.On average, the HCCwas 52.3 HU±25.90 less than the adjacent liver parenchyma in the arterial phase,57.31HU±26.44in the venous phase and 54.15HU±24.06 at the equilibrium phase. Metastases also showed an increasing in the attenuation pattern after contrast enhancement from 73.54HU±63.62in arterial phase to be increased in the venous phase80.94HU±67.50then it decreased to be 75.31 HU±57.30at the equilibrium phase .The study showed that there is a significant difference of the HU between all the detected liver lesions in all scanning phase at p= 0.000.The presence of liver enhancing lesions were in association with liver and spleen texture changes.Ascitis was found in most of the cases constituting 47(47%) of the cases. The study concludedthat triphasic CT Scan is an acknowledged imagingtool in characterizing liver lesions and evaluation of liver and spleen textural changes and detection of the associated findings