Sandeela Sattar, Mamoona Chiragh, Muhammad Saleem Akhtar, Basma Shahid.
Diagnostic accuracy of ultrasonography for diagnosis of hepatocellular carcinoma in patients with liver cirrhosis.
Biomedica Jan ;30(2):121-5.

Objective: To determine the diagnostic accuracy of USG for diagnosis of hepatocellular carcinoma in comparison to histopathology taking it is as gold standard, in patients with liver cirrhosis. Study Design: Cross – sectional. Place and Duration of Study: Radiology Department of Combined Military Hospital, Lahore, from 15 Nov., 2009 to 15 May 2010. Patients and Methods: Seventy patients with liver cirrhosis with a known mass, referred to the Radio- logy department, fulfilling the inclusion criteria were included. Ultrasonography was done with TOSHI- BA NEMIO and LOGIC 2000 ultrasound machines, using low frequency curvilinear probe with a fre- quency of 3.5 MHz. Ultrasound guided aspiration was performed using an 18G needle under full aseptic measures. Ultrasonographic findings were validated by histopathology reports. Results: Mean age of the study population was 60.39 ± 10.9 years. 47 (67.1%) of the patients were males and 23 (32.9%) were females. Risk factors for hepatocellular carcinoma were HCV infection in 27 (38.6%), HBV infection in 11 (15.7%). Mean size of the lesions was 4.59 ± 1.08 cm. The lesions were cha- racterized as being isoechoic, hypoechoic or hyperechoic as compared to the liver parenchyma. Com- pared to histopathologic findings, accuracy of the ultrasound findings was determined. Sensitivity of ultrasonography in detection of hepatocellular carcinoma was 92.3%. Specificity was 55.5%. Positive predictive value was 85.7% and negative predictive value was 71.4%. Conclusion: Conventional ultrasonography can be used as a screening tool in patients with advanced liver cirrhosis and for surveillance purposes. However further workup is required for definitive diag- nosis.

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