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KMID : 1033520120030010032
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Korean Society of Medical Sonographers
2012 Volume.3 No. 1 p.32 ~ p.39
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Study for evaluation of accuracy by classification of ultrasound pattern for Hepatic hemangioma in a Health Promotion Center
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Kim Y.-M.
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Abstract
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Objective : Hepatic hemangioma is a kind of benign tumor appeared in liver. To make a diagnosis of hepatic hemangioma is very important because it is difficult to distinguish hepatic hemangioma between other liver disease. Typical sonographic findings for hepatic hemangioma are well known but in case of fatty liver complication, accurate diagnosis is difficult because of non-typical sonographic findings. In this study, authors performed a retrospective analysis by classifications of echo patterns in sonographic findings by size and fatty liver presence. Eventually, authors studied relationship between selected factors and echo patterns and clinical meaning of diagnosis.
Method : The study was performed for 79 people confirmed among 459 people who were suspected of hepatic hemangioma by abdominal sonography in Samsung Medical Center in 2010. People who had liver disease and hepatitis were excluded since these diseases could cause changes of echo textures. 3 groups were classified by size and normal and fatty acid group were classified by liver condition at baseline. Sonographic findings were classified to 4 groups by combination of internal echo and marginal echo. To analyse accuracy of sonography, confirmation results by CT were classified to 3 groups.
Results : 105 cases of 79 people were suspected of hepatic hemangioma by sonographic findings. The number of cases for diameter x≤15mm, 16mm30mm by classification of size were 55 cases(52.4%), 42 cases(40%) and 8 cases(7.6%), respectively. The number of cases for normal, fatty liver I phase, II phase, III phase and IV phase by classification of liver condition were 81 cases(77.1%), 9 cases(8.6%), 6 cases(5.7%), 7 cases(6.7%) and 2 cases(1.9%), respectively. Among normal 81 cases, the number of cases for hyper, mixed, hypo, rim were 56 cases(69.1%), 11 cases(13.6%), 5 cases(6.2%), 9 cases(11.1%), respectively. Among fatty liver 24 cases, the number of cases for hyper, mixed, hypo, rim were 9 cases(37.5%), 0 cases(0.0%), 14 cases(58.3%), 1 cases(4.2%), respectively. By CT results of 105 cases, the number of cases for confirmations of hepatic hemangioma, confirmations of other liver disease and non-confirmation of any disease were 85 cases(81.0%), 10 cases(9.5%), 10 cases(9.5%), respectively.
Conclusion : Like established reports that non-typical sonographic findings were increased when the size is large, authors could find hyper-echo masses were mainly observed in case of hepatic hemangioma with size ≤15mm and the CT results for these cases were quite accurate. Even many established reports demonstrate hypo-echo masses were observed in case of hepatic hemangioma with fatty liver, authors could find hyper-echo and hypo-echo masses were observed equally. Of course, in consideration of relative ratio, authors could find many hypo-echo in fatty liver than normal. Furthermore, authors found different echo patterns in same liver condition. Authors could presume sonographic findings could be changeable by mass internal changes.
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KEYWORD
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Hepatic hemangioma, Liver neoplasms, Fatty liver, Abdominal sonography, Liver CT
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