Accuracy of ultrasound in detection of Hepatocellular Carcinoma in cirrhotic patients.
Objectives: Evaluate the accuracy of ultrasonography in the diagnosis of hepatocellular carcinoma among cirrhotic patients by comparing it with contrast enhanced multiphasic MRI. Study Design: Cross sectional study. Setting: Radiology Department through OPD\Admitted\emergency, Allied Hospital, Faisalabad. Period: 01-01-2018 to 30-06-2018. Material & Methods: A total of 91 cases, having symptoms of fatigue, weakness, vomiting, nausea, loss of appetite, abdominal pain, weight loss and bloating when the fluid is accumulated in abdominal cavity, itching, spider-like blood vessels on the skin were included in the study. Informed written consent was taken from all the patients or their next of kin after explaining the procedure, objectives and benefits of study. All the patients were examined with Conventional gray scale ultrasound using curvilinear probe of 5MHz and then with 1.5 tesla MR imager. Results: The diagnostic accuracy was computed as 42.86%(n=39) as true positive, 1.10%(n=1) as false positive, 49.45%(n=45) false negative and 6.59%(n=6) had true negative, while 46.43%(sensitivity), 85.71%(specificity), 97.5%(positive predictive value), 88.24%(negative predictive value), and 49.45%(diagnostic accuracy) were calculated. Conclusion: We concluded that the accuracy of ultrasonography for the diagnosis of hepatocellular carcinoma among cirrhotic patients by comparing it with contrast enhanced multiphasic MRI is in agreement with the previous studies, though its accuracy rate is lower but specificity is significantly higher and recommended in our country in low resource settings and tertiary care setups where diagnostic facilities are limited functional.