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Focal hepatic solid lesions incidentally detected on initial ultrasonography in 542 asymptomatic patients

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Abstract

Purpose

The purpose of this study is to evaluate the clinical significance of focal hepatic solid lesions incidentally detected on initial ultrasonography in asymptomatic patients.

Methods

From January 2009 to December 2009, 2670 initial ultrasonographies were performed in asymptomatic population. Of these 2670 initial examinations, 681 focal hepatic solid lesions in 542 patients (mean 39.4 years, range 23–73 years) were detected. Clinical information, ultrasonography features, and the outcome of these lesions were analyzed.

Results

Six hundred and seventy four lesions (99.0%) in 539 patients (99.4%) were benign, while seven lesions (1.0%) in three patients (0.6%) proved to be malignant. Risk factors significantly associated with malignant focal hepatic solid lesions were known history of malignancy, history of hepatitis, a positive result for the hepatitis B surface antigen, and abnormally elevated tumor markers. No malignancy was identified in patients without any one of these four risk factors. Ultrasonographic features of internal heterogeneous echotexture with peripheral hypoechoic rim showed significant associations with malignancy.

Conclusions

Focal hepatic solid lesions incidentally detected on initial ultrasonography were rarely malignant, especially in patients without these risk factors. Therefore, the knowledge of these risk factors and US features is important in order to make a differential diagnosis between benign and malignant focal hepatic lesions.

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Abbreviations

US:

Ultrasonography

CT:

Computed tomography

MRI:

Magnetic resonance imaging

HCC:

Hepatocellular carcinoma

AST:

Aspartate transaminase

ALT:

Alanine transaminase

ALP:

Alkaline phosphatase

HBsAg:

Hepatitis B surface antigen

HBsAb:

Hepatitis B surface antibody

CEA:

Carcinoembryonic antigen

CA19-9:

Carbohydrate antigen 19-9

CA-125:

Cancer antigen 125

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Authors and Affiliations

  1. Department of Health Resource Development, Korea Health Promotion Foundation, 173 Toegye-ro, Jung-gu, Seoul, 100-705, Korea

    Sang Hyun Choi

  2. Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Pungnap 2-dong, Songpa-ku, Seoul, 138-736, Korea

    Sang Hyun Choi

  3. Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 108 Pyung dong, Jongno-gu, Seoul, 110-746, Korea

    Heon-Ju Kwon, So-Yeon Lee, Hee Jin Park, Mi Sung Kim, Eun Chul Chung & Hae Won Park

  4. Department of Pathology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 108 Pyung dong, Jongno-gu, Seoul, 110-746, Korea

    Jin Hee Sohn

Authors
  1. Sang Hyun Choi
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Corresponding author

Correspondence to Heon-Ju Kwon.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

For this retrospective study, formal consent is not required.

Additional information

This study was performed at the Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine.

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Choi, S.H., Kwon, HJ., Lee, SY. et al. Focal hepatic solid lesions incidentally detected on initial ultrasonography in 542 asymptomatic patients. Abdom Radiol 41, 265–272 (2016). https://doi.org/10.1007/s00261-015-0567-9

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  • DOI: https://doi.org/10.1007/s00261-015-0567-9

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