ROLE OF ULTRASOUND ELASTOGRAPHY IN EVALUATION OF FOCAL LIVER LESIONS

DR HIMANSHU SONI; DR JITENDRA RATHAVA; DR. RUPAL VADHIYA; DR. BHAVYA CHAUHAN

Volume : VIII, Issue : III, March - 2019

ROLE OF ULTRASOUND ELASTOGRAPHY IN EVALUATION OF FOCAL LIVER LESIONS

Dr Himanshu Soni, Dr Jitendra Rathava, Dr. Rupal Vadhiya, Dr. Bhavya Chauhan

Abstract :

Introduction:Ultrasonographic elastography is a new noninvasive imaging technique that can be used to depict relative tissue stiffness or displacement (strain) in response to an imparted force. Stiff tissues deform less and exhibit less strain than compliant tissues in response to the same applied force. Acoustic Radiation Force Impulse (ARFI) imaging is an ultrasound elastography technique where a short, high intensity focused ultrasound beam is introduced for target tissue displacement. This technique has enabled liver elastography by transmission of the acoustic wave between the ribs or from the sub–costal area. Different features can be shown on ARFI elastography according to the type of liver tumor and that quantification of tumor stiffness may be helpful in the diagnosis. Aim and objectives:The aim of our study is to evaluate the role of ultrasound elastography in differentiating benign and malignant focal liver lesions. Materials and Methods:After ethical clearance, a prospective study was carried out in the Gujarat Cancer and Research In statute, Ahmedabad, from May 2016 to October 2018. After obtaining consent, 50 patients with focal liver lesions were studied. USG and elastography of focal liver lesions performed and ARFI value of lesions measured. The final diagnosis was confirmed by CT and/or trucut biopsy in selected patients for histopathological confirmation. The diagnosis on the basis of contrast enhanced CT and histopathology was considered to be the gold standard. Results:Sensitivity and specificity of the USG for the diagnosis of the Malignancy is 96.67% and 70% while the accuracy is the 86 % in this study.Maximum observation of the benign lesion shear wave value is fall within the range of the 1.3 to 1.9 m/s density in elastography and for malignant lesions 2.70 to 3.10 m/s. Conclusion:ARFI elastography is more sensitive and specific than USG in discriminating between benign and malignant lesions at 2.0 m/s with sensitivity and specificity of 96% and 95% respectively. ARFI elastography has also higher accuracy of 96%. ARFI elastography is very useful in differentiating benign from malignant focal liver lesions.