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2017, Number 2

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Anales de Radiología México 2017; 16 (2)

Assessment of hepatic lesions by multiphase multislice tomography: proposal for structured reporting

Illescas-Cárdenas J, Rodríguez-Nava P, Dena-Espinoza E

Language: Spanish
References: 38
Page: 87-101
PDF size: 505.82 Kb.


ABSTRACT

Background: multislice computed tomography with multiphase technique (4 phases) offers the opportunity to characterize hepatic lesions by combining images obtained before and after administering intravenous contrast medium with a power injector; it also provides a means of studying the behavior of lesions in different vascular phases. Objetive: establish the usefulness of a study protocol using multislice computed tomography with multiphase technique to assess hepatic lesions, and propose structured reporting which ensures accurate interpretation and the most precise diagnosis possible.
Material and Methods: a prospective, transverse, observational, and descriptive study, in the period from April 1 through December 15, 2016, in patients in outpatient consultation and hospitalization in the areas of general surgery, gastroenterology, and hepatobiliary clinic, with presumptive diagnosis of hepatic lesion. Statistical analysis of results was performed with simple frequencies and percentage distribution. 38 patients with indication of multislice and multiphase computed tomography due to suspected hepatic lesion were screened and analyzed. They were 12 men (32%) and 26 women (68%) in a ratio of 2:1, with an age range of 32 to 80 years (mean age 58).
Results: of the total lesions analyzed, 17 (44.7%) were malignant and 21 benign (55.2%). Of the malignant lesions, the most common diagnosis was hepatocellular carcinoma (32%). The most common benign lesion was hemangioma (18%). We propose structured reporting which assesses the characteristics necessary to establish a diagnosis with greater precision.
Conclusions: multislice computed tomography with multiphase technique (4 phases) helps characterize benign and malignant hepatic lesions based on their behavior with contrast medium, which is fundamental to diagnose hepatocellular carcinoma, whose characteristic reinforcement avoids the need for biopsy. Systematized use of structured reporting of hepatic lesions will help provide more precise, higher quality findings and avoid omissions, which enhances the diagnostic certainty of multislice computed tomography.


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