Journal List > J Korean Soc Radiol > v.70(5) > 1087398

Jang, Park, Park, and Seong: Evaluation of the Accuracy of Abdominal Ultrasound Focusing on the Missed Lesions Based on the Abdominal Computed Tomography in Health Screening

Abstract

Purpose

To evaluate the accuracy of abdominal ultrasonography (US), and the incidence, size and types of lesions, easily missed on abdominal US in health screening.

Materials and Methods

We retrospectively enrolled 311 physical checkup patients (male-to-female ratio, 156:155; mean age, 53.1 years), who underwent screening abdominal US and abdominal computed tomography (CT) on same day from July, 2011 to October, 2013. Per-organ and per-lesion analyses and verification of size and location of renal and hepatic lesions which were frequently missed on abdominal US were performed.

Results

Overall, 209 additional lesions were found on abdominal CT in 140 physical checkup patients and the missing rate of the lesion was 45%. Renal lesions were most common (105 lesions), followed by hepatic lesions (91 lesions). In renal and hepatic lesions which were missed on abdominal US, most (93.4%, 93.5%) lesions were less than 1.5 cm in longitudinal diameter. Most of missed renal lesions were located in mid portion of left kidney (24.7%). Most of the missed hepatic lesions on US were located in the hepatic dome (segment 7, 8, 2) (66%).

Conclusion

An awareness of the prevalence and location of easily missed lesions on screening abdominal US is helpful to enhance diagnostic performance of abdominal US in physical checkup patients.

Figures and Tables

Fig. 1
A 65-year-old male with adrenal adenoma in right adrenal gland (arrow), that was not found on abdominal ultrasonography, though it could be detected on contrast enhanced abdominal CT.
jksr-70-363-g001
Fig. 2
A 42-year-old female with renal stone.
A. Ultrasonography shows no abnormal finding in right kidney.
B. There is a tiny right renal stone (arrow), that was not found on ultrasonography, in lower pole on contrast enhanced abdominal CT.
jksr-70-363-g002
Fig. 3
A 50-year-old male with tiny hepatic cyst with peripheral calcification (arrow) in S8 of the liver, that was not found on abdominal ultrasonography.
jksr-70-363-g003
Fig. 4
A 39-year-old female with hepatic hemangioma which was not detected on ultrasonography. Poral phase CT shows a centripetal enhancing lesion (arrow) in S8 of the liver. The size of the lesion is 2.3 cm and the lesion was regarded as hemangioma.
jksr-70-363-g004
Table 1
Per-Organ Analysis of Missed Lesions
jksr-70-363-i001
Table 2
Size Verification of Missed Hepatic Lesions
jksr-70-363-i002
Table 3
Location and Size Verification of Missed Renal Lesions
jksr-70-363-i003
Table 4
Location of Missed Hepatic Lesions According to Couinaud Segments
jksr-70-363-i004

References

1. Bennett GL, Krinsky GA, Abitbol RJ, Kim SY, Theise ND, Teperman LW. Sonographic detection of hepatocellular carcinoma and dysplastic nodules in cirrhosis: correlation of pretransplantation sonography and liver explant pathology in 200 patients. AJR Am J Roentgenol. 2002; 179:75–80.
2. Kudo M, Okanoue T. Japan Society of Hepatology. Management of hepatocellular carcinoma in Japan: consensus-based clinical practice manual proposed by the Japan Society of Hepatology. Oncology. 2007; 72:Suppl 1. 2–15.
3. Bruix J, Sherman M, Llovet JM, Beaugrand M, Lencioni R, Burroughs AK, et al. Clinical management of hepatocellular carcinoma. Conclusions of the Barcelona-2000 EASL conference. European Association for the Study of the Liver. J Hepatol. 2001; 35:421–430.
4. Bruix J, Sherman M. Practice Guidelines Committee, American Association for the Study of Liver Diseases. Management of hepatocellular carcinoma. Hepatology. 2005; 42:1208–1236.
5. Park JW, Choi JY, Seo KS, Jeong JW, Seong JS, Kim JW, et al. Practice guidelines for management of hepatocellular carcinoma 2009. Seoul: Jingihoek;2009. p. 3–7.
6. Bolondi L, Sofia S, Siringo S, Gaiani S, Casali A, Zironi G, et al. Surveillance programme of cirrhotic patients for early diagnosis and treatment of hepatocellular carcinoma: a cost effectiveness analysis. Gut. 2001; 48:251–259.
7. Zhang B, Yang B. Combined alpha fetoprotein testing and ultrasonography as a screening test for primary liver cancer. J Med Screen. 1999; 6:108–110.
8. Lee CW, Choi JI, Kim MJ, Lee JS, Jung DC, Lee CY, et al. Added value of screening low dose computed tomography of the chest for the evaluation of abdominal solid organs by ultrasound in physical check-up patients. J Korean Soc Ultrasound Med. 2010; 29:97–104.
TOOLS
Similar articles