title: Focal hepatic lesions characterisation by different sonographic techniques: a prospective analysis.
abstract: BACKGROUND
  Ultrasound is usually the first diagnostic investigation for the assessment of liver lesions. Apart from conventional sonography (CS), new grey-scale sonographic techniques have been developed which have increased the application of ultrasound in liver imaging. The present study was undertaken to compare image quality of CS, real-time compound sonography (RTCS), tissue harmonic sonography (THS) and tissue harmonic compound sonography (THCS) in focal liver lesions.
  
  
  METHODS
  100 patients with focal hepatic lesions were enroled. Lesions were divided into solid and cystic group. Solid lesions were evaluated for lesion conspicuity and elimination of artefacts. For cystic lesions, lesion conspicuity, posterior acoustic enhancement and internal echoes within the lesion were evaluated. Grading was done using 3-5-point scales. Overall image quality was assessed depending on the total points.
  
  
  RESULTS
  78 solid and 22 cystic liver lesions were included. THCS showed superior results for lesion conspicuity, elimination of artefacts and overall image quality in solid lesions. RTCS showed similar results as THCS for lesion conspicuity and overall image quality in solid lesions. THS gave better results in cystic lesions for all imaging parameters. Results of THCS though slightly inferior, showed no significant difference from THS, in cystic lesions. CS was found to have least diagnostic value in characterisation.
  
  
  CONCLUSIONS
  For evaluation of focal hepatic lesions, a combination of compound and harmonic sonography, i.e. THCS, is the preferred sonographic technique.
authors.affiliation: Departments of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh, 160012 India.
authors.forename: Upasana
authors.initials: U
authors.lastname: Ranga
authors.affiliation: Departments of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh, 160012 India.
authors.forename: Naveen
authors.initials: N
authors.lastname: Kalra
authors.affiliation: Departments of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh, 160012 India.
authors.forename: Akshay K
authors.initials: AK
authors.lastname: Saxena
authors.affiliation: Departments of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh, 160012 India.
authors.forename: Anmol
authors.initials: A
authors.lastname: Bhatia
authors.affiliation: Departments of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh, 160012 India.
authors.forename: Manavjit S
authors.initials: MS
authors.lastname: Sandhu
authors.affiliation: Departments of Hepatology, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh, 160012 India.
authors.forename: Ajay K
authors.initials: AK
authors.lastname: Duseja
authors.affiliation: Departments of Hepatology, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh, 160012 India.
authors.forename: Yogesh K
authors.initials: YK
authors.lastname: Chawla
authors.affiliation: Departments of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh, 160012 India.
authors.forename: Niranjan
authors.initials: N
authors.lastname: Khandelwal
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014463:Ultrasonography / Q000379:methods*
keywords: Compound US; Liver; Liver lesions; Tissue harmonic imaging; Ultrasonography