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01.07.2010 | Hepatobiliary-Pancreas

Differentiation between true focal liver lesions and pseudolesions in patients with fatty liver: evaluation of helical CT criteria

verfasst von: Philippe Soyer, Marc Sirol, Yann Fargeaudou, Florent Duchat, Lounis Hamzi, Mourad Boudiaf, Mounir Aout, Youcef Guerrache, Eric Vicaut, Roland Rymer

Erschienen in: European Radiology | Ausgabe 7/2010

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Abstract

Objective

To determine the potential of helical CT for differentiating true lesions from pseudolesions in patients with fatty liver.

Methods

Helical CT of 44 patients with diffuse fatty liver (22 with true lesions; 22 with pseudolesions) were reviewed by two observers with regard to morphological features of visible lesions. Univariate analysis was used to detect discriminating criteria for the diagnosis of true lesions.

Results

Interobserver agreement was excellent for 9/10 morphological criteria (kappa = 0.831–1). True lesions were more frequently distant from the liver capsule (50.00% vs. 4.55%), located in the right lobe (72.73% vs. 31.82%), round (86.36% vs. 54.55%), heterogeneous (27.27% vs. 0.00%) and had ill-defined margins (40.91% vs. 13.64%) compared with pseudolesions (P < 0.05). Using univariate analysis, a location distant from the liver capsule was the most discriminating variable to differentiate between true and pseudolesions (P = 0.0060). Hyperattenuating content and round shape were the most sensitive criteria (sensitivity = 90.91% and 86.36%, respectively) for the diagnosis of true lesions, and heterogeneity, vascular displacement and encapsulation were the three most specific ones (specificity = 100.00%). Best accuracy was obtained with an association of the three variables (accuracy = 86.36%).

Conclusion

Helical CT provides objective and discriminating morphological criteria to differentiate between true lesions and pseudolesions in patients with fatty liver.

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Titel: Differentiation between true focal liver lesions and pseudolesions in patients with fatty liver: evaluation of helical CT criteria
verfasst von: Philippe Soyer
Marc Sirol
Yann Fargeaudou
Florent Duchat
Lounis Hamzi
Mourad Boudiaf
Mounir Aout
Youcef Guerrache
Eric Vicaut
Roland Rymer
Publikationsdatum: 01.07.2010
Verlag: Springer-Verlag
Erschienen in: European Radiology / Ausgabe 7/2010
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-009-1708-8

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Differentiation between true focal liver lesions and pseudolesions in patients with fatty liver: evaluation of helical CT criteria