Differential diagnosis of hepatic cystic lesions with gray-scale and color Doppler sonography.
OBJECTIVE
This study was conducted to evaluate the effectiveness of sonography, especially color Doppler sonography, in the differential diagnosis of cystic hepatic lesions.


METHODS
Ninety-two pathologically or clinically proven hepatic cystic lesions (20 cystic malignancies, 24 abscesses, and 48 simple cysts) were evaluated with gray-scale and color Doppler sonography. The sonographic features were analyzed retrospectively. The percentage, sensitivity, specificity, and positive and negative predictive values of the sonographic features of each disease category were calculated.


RESULTS
On gray-scale sonography, the simple cysts were easily distinguished from cystic malignancies and abscesses. While no significant differences were found between hepatic cystic malignancies and hepatic abscesses with respect to the number, shape, margin status, and presence of thick wall of the lesion, the presence of septation and mural nodules was significantly higher in the cystic malignancies than in abscesses. The sensitivity and specificity of color Doppler sonography in differentiating cystic malignancies from abscesses and simple cysts were 85% and 96%, respectively.


CONCLUSIONS
Color Doppler sonography provides information about blood flow that supplements that gained on gray-scale sonography, and the presence of color signals in the solid portion of the cystic lesions carries a high diagnostic value in differentiating hepatic cystic malignancies from abscesses and simple cysts.
Liang
Ping
P
Department of Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853 China.
Cao
Bingsheng
B
Wang
Yan
Y
Yu
Xiaoling
X
Yu
Dejiang
D
Dong
Baowei
B
D000328:Adult; D000368:Aged; D001783:Blood Flow Velocity; D003560:Cysts / Q000000981:diagnostic imaging* / Q000503:physiopathology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008099:Liver / Q000098:blood supply; D008100:Liver Abscess / Q000000981:diagnostic imaging / Q000503:physiopathology; D008107:Liver Diseases / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D018615:Ultrasonography, Doppler, Color / Q000379:methods*