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British Journal of Radiology (1992) 65, 202-206
© 1992 British Institute of Radiology
doi: 10.1259/0007-1285-65-771-202
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Duplex pulsed Doppler sonography in the differential diagnosis of hepatocellular carcinoma and other common hepatic tumours

Zu-Yau Lin, MD, MS Wen-Yu Chang, MD Liang-Yen Wang, MD Shinn-Cherng Chen, MD, MS Wan-Long Chuang, MD, MS Ming-Yuh Hsieh, MD and Jung-Fa Tsai, MD, DrMedSci

Department of Internal Medicine, Kaohsiung Medical College Hospital, 100 Shih-Chuan 1st Road, Kaohsiung City 807, Republic of China

180 previously untreated consecutive patients with liver tumours (308 lesions), including 104 hepatocellular carcinomas (148 lesions), 43 metastases (116 lesions) and 33 haemangiomas (44 lesions), were studied to determine the value of duplex sonography in the differentiation of hepatocellular carcinoma from other tumours. For lesions measuring ≤ 5 cm in diameter, hepatocellular carcinoma demonstrated the highest rate and haemangioma demonstrated the lowest rate of Doppler signals from within the lesions. To differentiate malignancy from haemangioma, the presence or absence of Doppler signals from these lesions were used as criteria. The specificity and positive predictive value were very high (100%, 100%), but the sensitivity, negative predictive value and accuracy were low (61.5%, 48.3%, 71.7%, respectively). With one exception, all lesions measuring < 3 cm in diameter with detectable Doppler signals were hepatocellular carcinoma. Using these results it is possible to differentiate hepatocellular carcinoma from metastases and haemangioma with high sensitivity, specificity, positive and negative predictive value, and accuracy (80.8%, 96.4%, 95.5%, 84.4%, 88.9%, respectively, for metastases; 80.8%, 100%, 100%, 81.5%, 89.6%, respectively, for haemangioma). We conclude that Doppler signals from within a lesion in combination with its size can aid differentiation of hepatocellular carcinoma from two other kinds of common hepatic tumour.

Key Words: Hepatocellular carcinoma • Metastatic liver cancers • Hepatic haemangioma • Ultrasound • Doppler studies

Received for publication April 8, 1991. Revision received July 11, 1991. Accepted for publication August 16, 1991.






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