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The diagnostic value of Doppler Resistive Index in the differential diagnosis of focal liver lesions Cover

The diagnostic value of Doppler Resistive Index in the differential diagnosis of focal liver lesions

Journal of Ultrasonography
Volume 23 (2023): Issue 93 (June 2023)
By: Yi Dong,  Wen-Ping Wang,  Andre Ignee,  Dan Zuo,  Yi-Jie Qiu,  Qi Zhang,  Xiu-Yun Lu,  Sheng Chen and  Christoph Frank Dietrich  
Open Access
|May 2023

Figures & Tables

Fig. 1.

The histogram of resistance index (RI) value of different focal liver lesions
The histogram of resistance index (RI) value of different focal liver lesions

Fig. 2.

A 49-year-old man was diagnosed with colorectal adenocarcinoma with multiple liver metastases lesions. On B-mode ultrasound (BMUS), a 66 × 38 mm heterogeneously hypoechoic lesion was detected in the left lobe of the liver (A). Color blood signals were detected within the lesion (B) with resistance index (RI) of 0.68 (C)
A 49-year-old man was diagnosed with colorectal adenocarcinoma with multiple liver metastases lesions. On B-mode ultrasound (BMUS), a 66 × 38 mm heterogeneously hypoechoic lesion was detected in the left lobe of the liver (A). Color blood signals were detected within the lesion (B) with resistance index (RI) of 0.68 (C)

Fig. 3.

A 29-year-old woman was diagnosed with focal nodular hyperplasia (FNH). On B-mode ultrasound (BMUS), a 70 × 62 mm heterogeneously hypoechoic lesion was detected in the right lobe of the liver (A). Color blood signals were detected within lesion (B) with resistance index (RI) of 0.41 (C)
A 29-year-old woman was diagnosed with focal nodular hyperplasia (FNH). On B-mode ultrasound (BMUS), a 70 × 62 mm heterogeneously hypoechoic lesion was detected in the right lobe of the liver (A). Color blood signals were detected within lesion (B) with resistance index (RI) of 0.41 (C)

Fig. 4.

A 52-year-old woman was diagnosed with intrahepatic cholangiocarcinoma (ICC). On B-mode ultrasound (BMUS), a 42 × 39 mm heterogeneously hypoechoic lesion was detected in the right lobe of the liver (A). Color blood signals were detected within the lesion (B) with resistance index (RI) of 0.56 (C)
A 52-year-old woman was diagnosed with intrahepatic cholangiocarcinoma (ICC). On B-mode ultrasound (BMUS), a 42 × 39 mm heterogeneously hypoechoic lesion was detected in the right lobe of the liver (A). Color blood signals were detected within the lesion (B) with resistance index (RI) of 0.56 (C)

Fig. 5.

A 66-year-old man was diagnosed with hepatocellular carcinoma (HCC). On B-mode ultrasound (BMUS), a 20 × 17 mm slightly hyperechoic lesion was detected in the right lobe of the liver (yellow arrow), under the background of liver cirrhosis (A). Color blood signals were detected within the lesion (B) with resistance index (RI) of 0.71 (C)
A 66-year-old man was diagnosed with hepatocellular carcinoma (HCC). On B-mode ultrasound (BMUS), a 20 × 17 mm slightly hyperechoic lesion was detected in the right lobe of the liver (yellow arrow), under the background of liver cirrhosis (A). Color blood signals were detected within the lesion (B) with resistance index (RI) of 0.71 (C)

Fig. 6.

A 54-year-old man was diagnosed with hepatocellular carcinoma (HCC). On B-mode ultrasound (BMUS), a 42 × 40 mm mixed echoic lesion was detected in the left lobe of the liver (A). Color blood signals were detected within the lesion (B) with resistance index (RI) of 0.70 (C)
A 54-year-old man was diagnosed with hepatocellular carcinoma (HCC). On B-mode ultrasound (BMUS), a 42 × 40 mm mixed echoic lesion was detected in the left lobe of the liver (A). Color blood signals were detected within the lesion (B) with resistance index (RI) of 0.70 (C)

Fig. 7.

A 71-year-old man was diagnosed with hepatocellular carcinoma (HCC). On B-mode ultrasound (BMUS), a 72 × 62 mm mixed echoic lesion was detected in the right lobe of the liver, with ill-defined margin (A). Color blood signals were detected within the lesion (B) with resistance index (RI) of 0.63 (C)
A 71-year-old man was diagnosed with hepatocellular carcinoma (HCC). On B-mode ultrasound (BMUS), a 72 × 62 mm mixed echoic lesion was detected in the right lobe of the liver, with ill-defined margin (A). Color blood signals were detected within the lesion (B) with resistance index (RI) of 0.63 (C)

Fig. 8.

A 48-year-old woman was diagnosed with hepatocellular carcinoma (HCC). On B-mode ultrasound (BMUS), a huge hyperechoic mass was detected in the right lobe of the liver (A). Color blood signals were detected within the lesion (B) with resistance index (RI) of 0.67 (C)
A 48-year-old woman was diagnosed with hepatocellular carcinoma (HCC). On B-mode ultrasound (BMUS), a huge hyperechoic mass was detected in the right lobe of the liver (A). Color blood signals were detected within the lesion (B) with resistance index (RI) of 0.67 (C)

Fig. 9.

A 45-year-old man was diagnosed as with hemangioma. On B-mode ultrasound (BMUS), a 45 × 35 mm mixed echoic mass was detected in the right lobe of the liver, with an ill-defined margin (A). Color blood signals were detected within the lesion (B) with resistance index (RI) of 0.51 (C)
A 45-year-old man was diagnosed as with hemangioma. On B-mode ultrasound (BMUS), a 45 × 35 mm mixed echoic mass was detected in the right lobe of the liver, with an ill-defined margin (A). Color blood signals were detected within the lesion (B) with resistance index (RI) of 0.51 (C)

Comparison of resistance index in hepatocellular carcinoma in different liver background

GroupBackgroundNumberRI (mean ± SD)
1*normal820.69 ± 0.12
2Fatty liver160.75 ± 0.11
3*cirrhosis1560.73 ± 0.12

Comparison of resistance index in focal nodular hyperplasia lesions (FNH)

GroupNumberSize of FNH (cm)RI (mean ± SD)
13<20.47 ± 0.05
2282–50.56 ± 0.07
3165–100.54 ± 0.08
41>100.49

RIs for different focal liver lesions

Pathological diagnosisProportion n/all (%)RI (range)RI (mean ± SD)
Malignant lesions332/458 (72.5%)0.43–1.000.71 ± 0.12
        Hepatocellular carcinoma254/347 (73.2%)0.43–1.000.72 ± 0.12
        Liver metastasis30/51 (58.82%)0.52–1.000.70 ± 0.10
        Intrahepatic cholangiocarcinoma35/44 (79.5%)0.51–1.000.68 ± 0.10
        Mixed hepatocellular Cholangiocarcinoma3/5 (60%)0.68–0.820.73 ± 0.08
        Sarcomatoid carcinoma3/4 (72.5%)0.69–0.720.71 ± 0.02
        Epithelioid cell tumor3/3 (100%)0.45–0.590.51 ± 0.07
Benign lesions100/118 (84.7%)0.35 – 0.840.54 ± 0.10
        Focal nodular hyperplasia48/52 (92.3%)0.40–0.690.54 ± 0.08
        Angiomyolipoma15/16 (93.8%)0.35–0.720.51 ± 0.09
        Hemangioma14/23 (60.9%)0.35–0.660.51 ± 0.09
        Hepatocellular adenoma8/9 (88.9%)0.42–0.660.51 ± 0.08
        Inflammatory pseudotumors4/5 (80%)0.58–0.840.68 ± 0.12

Comparison of resistance index in hepatocellular carcinoma (HCC)

GroupNumberSize of HCC (cm)RI (mean ± SD)
1*63< 20.73 ± 0.12
2#1132–50.75 ± 0.12
3635–100.70 ± 0.11
4*, #15>100.61 ± 0.13
DOI: https://doi.org/10.15557/jou.2023.0010 | Journal eISSN: 2451-070X | Journal ISSN: 2084-8404
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Language: English
Page range: e45 - e52
Submitted on: Oct 9, 2022
Accepted on: Jan 3, 2023
Published on: May 11, 2023
Published by: MEDICAL COMMUNICATIONS Sp. z o.o.
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year
Keywords:
B-mode ultrasound (BMUS),
focal liver lesion (FLL),
resistance index (RI),
hepatocellular carcinoma (HCC),
focal nodular hyperplasia (FNH)
Related subjects:
Medicine,
Basic medical science,
Basic medical science, other

© 2023 Yi Dong, Wen-Ping Wang, Andre Ignee, Dan Zuo, Yi-Jie Qiu, Qi Zhang, Xiu-Yun Lu, Sheng Chen, Christoph Frank Dietrich, published by MEDICAL COMMUNICATIONS Sp. z o.o.
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

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