ДИФЕРЕНЦИЈАЛНО ДИЈАГНОСТИЧКА ВРЕДНОСТ НА ДОПЛЕР ЕХОТОМОГРАФИЈАТА ПРИ ФОКАЛНИТЕ ПАРЕНХИМНИ ЛЕЗИИ НА ЦРНИОТ ДРОБ

Avramovski, Petar and Siljanovski, Simeon (2008) ДИФЕРЕНЦИЈАЛНО ДИЈАГНОСТИЧКА ВРЕДНОСТ НА ДОПЛЕР ЕХОТОМОГРАФИЈАТА ПРИ ФОКАЛНИТЕ ПАРЕНХИМНИ ЛЕЗИИ НА ЦРНИОТ ДРОБ. MEDICUS, 10 (2). pp. 2-14. ISSN 1409-6366

Text 1. МЕДИКУС, Фокални паренхимни лезии.pdf - Published Version Download (537kB)

Abstract

Extensive use of B-mode ultrasonography has led to the detection of a large
number of small hepatic focal lesions in general practice. However, differential diagnosis
of benign and malignant liver lesions may be difficult, even with clinical, biochemical
data, and imaging techniques. Color Doppler flow imaging can provide information on
different blood flow model in liver parenchymatous focal lession. After the
morphological characteristics of the lesions were assessed by B mode, Color Doppler
ultrasound was used to determine the distribution, intra-and/or peritumoral vessels, and
pulsed Doppler was used to point the interested lesions. The aim of our study was to
develop standard protocol of color Doppler ultrasound for liver focal parenchymatous
lesion and to assess resistance index (RI) and Doppler perfusion index (DPI) in
differential diagnosis of liver lesions. From 2002 to 2005, 120 patients with hepatic focal
solid lesions were studied (84 males, 36 females) their age ranged from 35-72 years. The
lesions included: malignant: primary malignant tumor (14), cholangiocarcinoma (6) and
initial metastasis (40); benignant: hemangioma (14), angiomyolipoma (6), hepatic
adenoma (16), hepatic lipoma (8), cirrhotic nodules (6), absces (4) and focal nodual
hyperplasia (6). All of them were proved with another imaging methods: EMR, KTM and
Ultrasound guided biopsy. We used color Doppler ultrasonography with spectral signal
analysis to measure resistance index in artery flow in focal lesion and liver Doppler
perfusion index (DPI). We measure the RI and DPI at 60 healthy volunteers. Estimating
flow parameters we find that mean PvFV=1559,03  85,73mL/min, mean
HaFV=296,65  29,66mL/min, I calculate that RI=0,607  0,02 by equation
max
max min
V
V V
HaRI

 and DPI=0,1595  0,01158 with next equation:
HaFV
PvFV HaFV
DPI

 . Intratumoral and peritumoral arterial flow signals were obtained
in 90% of the malignant tumors, and in 46,66% of benign lesions (P<0.01). The average
value of RI in primary malignant liver tumors was RI=0,746  0,037 and RI=0,723  0,01
in metastatic tumors (the difference between them was not statistically significant) but it
was significantly higher than that in benign ones RI=0,547  0, 74. There were significant
differences between malignant and benign tumors. There were no significant differences
in DPI value between them and reference value of DPI, except the value of DPI during
metastases DPI=0,35  0,08 compared with reference value of DPI=0,1595  0,01158. In
[Type text]
conclusion, the type of flow signals (arterial and/or venous) are helpful in differentiating
benign from malignant lesions. The presence of intratumoral venous flow is strongly
suggestive of benign tumors. When intra-and/or peritumoral arterial blood flow is found,
RI<0.6 would strongly suggest a benign tumor. Simultaneous occurrence of both intraand
peritumoral arterial flow and RI>0.6 would strongly suggest malignancies. Color
Doppler ultrasonography would be more helpful in differential diagnosis of benign and
malignant liver tumors, with aid of the value of resistance index RI and spectral analysis
like powerful tool.
Key words: focal parenchymatous lesion, resistance index (RI), perfusion index (DPI),
Doppler, differential diagnosis.

Item Type:	Article
Subjects:	Scientific Fields (Frascati) > Medical and Health Sciences > Clinical medicine
Divisions:	UKLO Network
Depositing User:	UKLO Mrezha
Date Deposited:	27 May 2024 05:59
Last Modified:	27 May 2024 05:59
URI:	https://eprints.uklo.edu.mk/id/eprint/9931

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