Triphasic Computed Tomography for Characterization of Liver Lesions Identified on Ultrasonography

Abstract

Background: Liver disease is the leading cause of death in Pakistan and Asia. Liver carcinoma is the most prevalent cancer in the world. Identification of cancer at an early stage can help in better management of the disease and improved prognosis. Computed tomography can perform scans at different phases after contrast is administered. It is the most effective tool for the diagnosis of tumors and different types of lesions. Our objective of the study was to characterize the liver lesions identified on ultrasonography and differentiate between benign and malignant lesions at Bilal Hospital Rawalpindi. Methods: This cross-sectional quantitative study was conducted at Bilal Hospital, Rawalpindi, Pakistan, to evaluate liver lesions using triphasic CT. Data from 50 reports were analyzed, focusing on hepatic lesions, hepatomegaly, cirrhosis, and portal hypertension identified through ultrasonography. Patients over 30 were included, while those under 30, pregnant, contrast-allergic, or with abnormal renal function tests were excluded. Triphasic CT scans were performed with a 64-slice scanner, capturing arterial, portal venous, and delayed phases after contrast injection. Radiologists reported the scans, and data were analyzed using SPSS-25, ensuring patient consent, confidentiality, and privacy. Results: In this study, 28% of patients had benign liver lesions, with focal nodular hyperplasia (14%) being the most common, followed by hepatic cysts (4%) and hemangiomas (10%). Malignant lesions were observed in 62% of patients, with hepatocellular carcinoma (36%) being the most prevalent, followed by secondary metastases (10%), cholangiocarcinoma (8%), and focal hepatic lesions (8%). The most frequently observed condition was hepatocellular carcinoma. Conclusions: The study concludes that there is a significant prevalence of both benign and malignant liver lesions in patients over 30 years, with hepatocellular carcinoma being the most common malignancy and focal nodular hyperplasia, the most frequent benign lesion. The findings emphasize the crucial role of triphasic CT in accurately diagnosing and differentiating liver lesions, aiding in effective treatment planning.