Semiquantitative strain elastography of liver masses.
OBJECTIVE
This study was designed to determine the utility of semiquantitative strain elastography in differential diagnosis of solid liver masses.


METHODS
A total of 103 patients with focal liver masses underwent abdominal sonographic examinations and freehand elastography of focal hepatic lesions. Eighty-two patients (79.7%) with 93 focal hepatic lesions were included in the study. Twenty-one patients (20.3%) were excluded from the study because of technical limitations of semi-quantitative strain elastography and difficulty in detection of normal liver parenchyma on gray-scale sonography. We evaluated different focal hepatic lesions such as hemangiomas, focal nodular hyperplasia, nodular regenerative hyperplasia, adenomas, hepatocellular carcinomas, metastases, and cholangiocarcinomas. The stiffness of the lesions was determined by measurement of strain values on semiquantitative strain elastography. The strain index value (strain ratio of liver parenchyma and focal lesions) of each lesion was calculated. Mean strain index values of benign and malignant liver lesions were compared.


RESULTS
The mean strain index value of malignant liver lesions ± SD (2.82 ± 1.82) was significantly higher than that of benign liver lesions (1.45 ± 1.28; P< .0001). Hemangiomas had a significantly lower mean strain index value than other benign lesions (P < .0034). There was no statistically significant difference between strain index values of different types of malignant lesions (P > .05).


CONCLUSIONS
Semiquantitative strain elastography may be helpful for differentiating benign and malignant liver masses. The substantial overlap between strain index values of benign and malignant liver masses limits clinical usefulness of this technique.
Department of Radiology, Faculty of Medicine, University of Firat, Hastanesi Rektorluk Kampusu 23119 Elazig, Turkey. ruhionur@yahoo.com
Mehmet Ruhi
MR
Onur
Ahmet Kursad
AK
Poyraz
Esra Ercin
EE
Ucak
Zulkif
Z
Bozgeyik
Ibrahim Hanifi
IH
Özercan
Erkin
E
Ogur
D000328:Adult; D000368:Aged; D000465:Algorithms; D055119:Elastic Modulus; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D055815:Young Adult