title: Characterization of focal hepatic lesions with duplex sonography: findings in 198 patients.
abstract: OBJECTIVE
  The purpose of this study was to determine the value of duplex Doppler sonography in the characterization of focal hepatic lesions.
  
  
  METHODS
  Duplex Doppler sonography with a 3-MHz transducer was performed prospectively on 198 patients with focal hepatic lesions. One hundred thirty-two patients had pathologically proved diagnoses, confirming 46 hepatomas and 86 metastatic lesions. Twenty-three hemangiomas were confirmed either with tissue, tagged RBC study, MR imaging, or hemangioma CT protocol. Forty-three patients with no history of cancer had benign lesions that were established on the basis of follow-up imaging and at least a 2-year clinical history with no evidence of cancer.
  
  
  RESULTS
  Thirty-two hepatomas and four metastatic lesions had Doppler shifts of 4.5 kHz or more, giving a 70% sensitivity, 95% specificity, and 89% positive predictive value in distinguishing hepatomas from metastatic lesions. Forty-three hepatomas, 47 metastatic lesions, one hemangioma, and three benign lesions had Doppler shifts of 1.75 kHz or more, giving a 68% sensitivity, 94% specificity, and 96% positive predictive value in distinguishing malignant from benign lesions. Doppler shifts (mean +/- SD) were as follows: hepatomas, 4.72 +/- 1.72 kHz; metastases, 1.99 +/- 1.63 kHz; and hemangiomas, 0.53 +/- 0.75 kHz. These differences in mean Doppler shifts were statistically significant (p < .0001).
  
  
  CONCLUSIONS
  Duplex Doppler sonography aids in distinguishing hepatomas from metastases and malignant from benign hepatic lesions with a high degree of specificity but low sensitivity.
authors.affiliation: Department of Diagnostic Radiology, Montreal General Hospital, McGill University School of Medicine, Quebec, Canada.
authors.forename: C
authors.initials: C
authors.lastname: Reinhold
authors.forename: L
authors.initials: L
authors.lastname: Hammers
authors.forename: C R
authors.initials: CR
authors.lastname: Taylor
authors.forename: C L
authors.initials: CL
authors.lastname: Quedens-Case
authors.forename: C K
authors.initials: CK
authors.lastname: Holland
authors.forename: K J
authors.initials: KJ
authors.lastname: Taylor
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000556:secondary; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006391:Hemangioma / Q000175:diagnosis*; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012372:ROC Curve; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D014057:Tomography, X-Ray Computed; D018616:Ultrasonography, Doppler, Duplex