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International Journal of Medicine Sciences

Vol. 2, Issue 2, Part A (2020)

Ultrasound guided interventions in the diagnosis and management of hepatic lesions

Author(s):

Md khizer Razak, Sudhakar R

Abstract:

Background:Space occupying lesions of the liver are frequently reported during imaging of the abdomen. Patients with these lesions may be symptomatic or asymptomatic. Most of these lesions have nonspecific imaging findings. Hepatic lesions can be inflammatory like abscesses, benign lesions like hemangiomas or malignant lesions like hepatocellular carcinoma. Guided interventions in the liver may be for diagnostic purposes like fine needle aspiration cytology or biopsy for focal lesions or for therapeutic purposes like fine needle aspiration cytology (FNAC) or catheter drainage for abscesses and collections. Aims and objectives: The aims of this study were 1) to conduct US guided biopsy in hepatic lesions and to evaluate the safety of procedures as well as quality and adequacy of specimens obtained. 2. To conduct US guided aspiration or catheter drainage of hepatic abscesses and to evaluate the clinical outcome. 3. The utility of these ultrasound guided interventions to laboratory procedures. Methods:The study is a hospital based observational study of ultrasound guided interventional procedures in patients with liver lesions (benign or malignant) for. The study includes patients both sexes with age ranging from 4 years to 80 years. The study period was for duration of 18 months from October 2018 to May 2019. The study includes two groups of patients, one with liver abscesses for drainage and other with focal or diffuse hepatic lesions for diagnostic biopsy or cytology under sonographic guidance referred from various departments Results:This study describes the safety of ultrasound guided interventions in patients with varying hepatic lesions, the quality and adequacy of specimens obtained in diagnostic biopsy and FNACs and the clinical out come in patients with hepatic abscess treated by percutaneous abscess aspiration. Ultrasound guided intervention was performed in 55 patients with varying hepatic lesions. 25 patients with clinical and imaging diagnosis of hepatic abscess were treated with needle aspiration (21) or by pig tail catheter drainage (4). The patients were followed up until were discharged with complete clinical cure. Out of 25 patients only one patient was not cured and he had multiple complications due to liver abscess per se. Rest of 24 patients were completely cured with hospital stay ranging between 3 to 7 days after the procedure. Diagnostic biopsy (18) and FNAC (11) were performed in 29 patients with clinical and imaging diagnosis of malignant hepatic lesions. Out of 11 ultrasound guided FNACs one was suboptimal due to inadequate sample. Repeat trucut needle biopsy in that patient yielded adequate sample with histopathological diagnosis of hepatocellular carcinoma. The diagnostic yield of ultrasound guided FNAC was 91%. Conclusions:Ultrasonography is choice of image guidance as it provides real time visualization of needle (and catheter) position and movement, cost effective and free of ionizing radiation. Sonographically guided liver biopsy with 18-20-gauge automated gun biopsy needles is a safe procedure in expert hands with low morbidity. Ultrasound guided diagnostic biopsy or cytology providesrequisite and decent quality specimen for histopathological examination

Pages: 10-20  |  1068 Views  290 Downloads

How to cite this article:
Md khizer Razak, Sudhakar R. Ultrasound guided interventions in the diagnosis and management of hepatic lesions. Int. J. Med. Sci. 2020;2(2):10-20. DOI: 10.33545/26648881.2020.v2.i2a.21
International Journal of Medicine Sciences

International Journal of Medicine Sciences