title: Characteristics suggestive of focal Fatty sparing from liver malignancy on ultrasound in liver screening.
abstract: OBJECTIVE
  The objective of this study was to determine whether there are ultrasound characteristics that can be used to differentiate focal fatty sparing (FFS) from hepatocellular carcinoma and other liver malignancies in liver screening.
  
  
  METHODS
  Data of patients with FFS found at ultrasound were reviewed, 136 patients with FFS were included, and 112 patients with hepatocellular carcinoma and 65 patients with liver metastatic tumor (173 tumors) were selected as control group. Ultrasound and color Doppler characteristics of FFS and liver malignancies were studied. Some characteristics drawn from this study were used as reference to validate the liver malignancies and FFS, and sensitivity, specificity, and positive and negative predictive values were calculated.
  
  
  RESULTS
  Hyperechogenicity, isoechogenicity, heterogeneous echotexture, posterior acoustic shadowing, halo, hypervasculature presented exclusively in liver malignancies, posterior acoustic enhancement presented predominantly in liver malignancies, irregularly shaped morphology presented exclusively in FFS, arterial velocity, and maximal size of liver malignancies were significantly higher than those of FFS (P < 0.001). Halo presented in 109 of 285 liver malignancies (38.2%), but was absent in FFS (P < 0.001). The overall sensitivity, specificity, and positive and negative predictive values were 94.38%, 90.44%, and 95.39% and 88.49%, respectively.
  
  
  CONCLUSIONS
  Combination of hyperechogenicity, isoechogenicity, heterogeneous echotexture, posterior acoustic shadowing, posterior acoustic enhancement, halo appearance, and hypervascularity with high-speed artery has high sensitivity, specificity, and positive and negative predictive values for distinguishing liver malignancy and FFS.
authors.affiliation: Department of Medical Imaging, Affiliated Hospital of Hainan Medical College, Haikou, China.
authors.forename: Size
authors.initials: S
authors.lastname: Wu
authors.forename: Rong
authors.initials: R
authors.lastname: Tu
authors.forename: Guangqing
authors.initials: G
authors.lastname: Liu
authors.forename: Huang
authors.initials: H
authors.lastname: Li
authors.forename: Yanyan
authors.initials: Y
authors.lastname: Zhao
mesh_terms: D000328:Adult; D000368:Aged; D003937:Diagnosis, Differential; D055088:Early Detection of Cancer / Q000379:methods*; D005234:Fatty Liver / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014463:Ultrasonography / Q000379:methods*; D055815:Young Adult