Prevalence of benign focal liver lesions: ultrasound investigation of 45,319 hospital patients

AbstractPurposeThe aim of the study was to determine the sonographic prevalence of benign focal liver lesions on the basis of a population of hospital patients.Methods The ultrasound results in a population of (n = 45,319) hospital patients over a period of 10 years were examined retrospectively and evaluated for the diagnosis of benign focal liver lesions [hepatic cysts, hepatic hemangioma, focal nodular hyperplasia (FNH), hepatic adenoma, and focal fatty sparing]. Results that were incomplete or ambiguous were excluded from this study.ResultsAt least one of the lesions to be investigated was diagnosed in 15.1% (n = 6839) of the patients of the total population. The most commonly recorded lesion, with a total prevalence of 6.3% (n = 2839), was focal fatty sparing, followed by hepatic cysts with 5.8% (n = 2631). The prevalence of hepatic hemangioma was 3.3% (n = 1640), while that of FNH was 0.2% (n = 81) and that of hepatic adenoma was 0.04% (n = 19). An association between the occurrence of benign focal liver lesions and age was observed.ConclusionsThe calculated prevalence of benign focal liver lesions shows that on the fortuitous discovery of space-occupying lesions of the liver, first consideration should be given to focal fatty sparing, simple hepatic cysts and hemangiomas. The finding of a FNH or an adenoma is rarely a random discovery.

[1]  Let's go out of the breast: prevalence of extra-mammary findings and their characterization on breast MRI. , 2014, European journal of radiology.

[2]  Y. Ozsunar,et al.  Pseudolesions of left liver lobe during helical CT examinations: prevalence and comparison between unenhanced and biphasic CT findings. , 2005, European journal of radiology.

[3]  M. Bardella,et al.  Hepatic Hemangioma in Celiac Patients: Data from a Large Consecutive Series , 2015, Gastroenterology research and practice.

[4]  L. Martín Herrera,et al.  Hepatic tumors in patients with cirrhosis: an autopsy study. , 1997, Revista Espanola de Enfermedades Digestivas.

[5]  I. Rustamov,et al.  [Hemangioma of the liver]. , 1978, Klinicheskaia khirurgiia.

[6]  B. Boehm,et al.  Prevalence and Risk Factors of Focal Sparing in Hepatic Steatosis , 2010, Ultraschall in der Medizin.

[7]  M. Lafortune,et al.  Focal sparing of liver parenchyma in steatosis: role of the gallbladder and its vessels. , 1995, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.

[8]  D. Bluemke,et al.  CT of hepatic tumors: prevalence and specificity of retraction of the adjacent liver capsule. , 1994, AJR. American journal of roentgenology.

[9]  M. Falagas,et al.  Decreasing trends of ultrasonographic prevalence of cystic echinococcosis in a rural Greek area , 2010, European Journal of Clinical Microbiology & Infectious Diseases.

[10]  K. Lam.  Autopsy findings in diabetic patients: A 27-Yr clinicopathologic study with emphasis on opportunistic infections and cancers , 2002, Endocrine pathology.

[11]  L. MartínHerrera,et al.  Hepatic tumors in patients with cirrhosis: an autopsy study. , 1997 .

[12]  M. Caremani,et al.  Ecographic epidemiology of non‐parasitic hepatic cysts , 1993, Journal of clinical ultrasound : JCU.

[13]  D. Marin,et al.  Focal nodular hyperplasia-like lesions in patients with cavernous transformation of the portal vein: prevalence, MR findings and natural history , 2011, European Radiology.

[14]  N. L. Kester,et al.  Focal hypoechoic regions in the liver at the porta hepatis: prevalence in ambulatory patients. , 1995, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.

[15]  L. Chiche,et al.  Diagnosis and Management of Benign Liver Tumors , 2013, Seminars in Liver Disease.

[16]  Kaewalin Rungsinaporn,et al.  Frequency of abnormalities detected by upper abdominal ultrasound. , 2008, Journal of the Medical Association of Thailand = Chotmaihet thangphaet.

[17]  M. Sampson,et al.  The prevalence and characterization of simple hepatic cysts by ultrasound examination. , 1989, The British journal of radiology.

[18]  M. Thapar,et al.  Management of Hepatic Adenomatosis , 2015, Current Gastroenterology Reports.

[19]  G. Verros,et al.  Natural history of hepatic haemangiomas: clinical and ultrasound study. , 1991, Gut.

[20]  W. Manning,et al.  Prevalence of non-cardiac pathology on clinical transthoracic echocardiography. , 2012, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[21]  M. Feldman.  Hemangioma of the liver; special reference to its association with cysts of the liver and pancreas. , 1958, American journal of clinical pathology.

[22]  J. Laukkarinen,et al.  Diagnostic workup of liver lesions: Too long time with too many examinations , 2015, Scandinavian journal of gastroenterology.

[23]  M. Völk,et al.  Frequency of benign hepatic lesions incidentally detected with contrast-enhanced thin-section portal venous phase spiral CT. , 2001, Acta radiologica.

[24]  A. Okada,et al.  Hemangioma of the liver. Diagnosis with combined use of laparoscopy and hepatic arteriography. , 1975, American journal of surgery.

[25]  M. Horrow,et al.  Case 6: Diagnosis: "focal fatty sparing" of the caudate lobe mimicking a mass. , 2007, Ultrasound quarterly.

[26]  H. Schild,et al.  Häufigkeit und Bedeutung von kleinen fokalen Leberläsionen in der MRT , 2001 .

[27]  D. Schreiber-Dietrich,et al.  Fortuitously discovered liver lesions. , 2013, World journal of gastroenterology.

[28]  J. Zucman‐Rossi,et al.  Hepatocellular adenoma management and phenotypic classification: The Bordeaux experience , 2009, Hepatology.

[29]  O. Beahrs,et al.  Cystic Disease of the Liver , 1974, Review of surgery.

[30]  M. Friedrich-Rust,et al.  Contrast-Enhanced Ultrasound (CEUS) for the Characterization of Focal Liver Lesions – Prospective Comparison in Clinical Practice: CEUS vs. CT (DEGUM Multicenter Trial) Parts of this Manuscript were presented at the Ultrasound Dreiländertreffen 2008, Davos , 2009, Ultraschall in der Medizin.

[31]  P. Karhunen.  Benign hepatic tumours and tumour like conditions in men. , 1986, Journal of clinical pathology.

[32]  D. Pauleit,et al.  [Incidence and significance of small focal liver lesions in MRI]. , 2001, RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin.

[33]  L. Barthelmes,et al.  Liver cell adenoma and liver cell adenomatosis. , 2005, HPB : the official journal of the International Hepato Pancreato Biliary Association.

[34]  M. Völk,et al.  Frequency of benign hepatic lesions incidentally detected with contrast-enhanced thin-section portal venous phase spiral CT , 2001 .

[35]  E. Buscarini,et al.  High prevalence of hepatic focal nodular hyperplasia in subjects with hereditary hemorrhagic telangiectasia. , 2004, Ultrasound in medicine & biology.

[36]  M. Karçaaltıncaba,et al.  Imaging of hepatic steatosis and fatty sparing. , 2007, European journal of radiology.