Diagnostic Accuracy of Ultrasound for Benign and Malignant Hepatic Masses Taking Computed Tomography as Gold Standard

Detection of benign and malignant liver masses is very important for the treatment. Objectives: To determine the diagnostic accuracy of ultrasound for hepatic masses taking computed tomography as gold standard Methods: It was cross a sectional analytical study to.it involves 266 patients suffering from hepatocellular cell carcinoma age group 45 to 65 years visiting Department of Radiology THQ Hospital Hazro, both genders were included. Consecutive sampling method was used. The collection of data was done through questionnaire and analysis by using SPSS version 25. Results: This study enlisted the participation of 261 patients. The average age of all patients was 59.28 14 years, with a range of 45 to 65 years. It describes that the total number of true positive disease were 228 which was also detected on ultrasound. However, the occurrence of HCC is highest on CT scan when compared with adenoma and hemangioma. There were 28 patients with multiple lesions, with 71.4 % being malignant and 28.6 % being benign. On the other hand, 22 individuals had a single lesion, of which 36.4% were malignant and 63.6 % were benign (p 0.001). CT had a sensitivity of 96 % to diagnose a malignant lesion, a speci�city of 88.4 %, an accuracy of 95.78 %, a positive predictive value of 98.70 %, and a negative predictive value of 73.33 %. Conclusions: The results of the present study therefore concluded that CT is a useful modality for the diagnosis of malignant liver masses.Ultrasound had high sensitivity, speci�city for the hepatic masses. females were more effected than males. Among hepatic masses, HCC is the commonest.

. Hepatocellular carcinoma might be shown by a past lled with hepatitis B, C, or cirrhosis of the liver (HCC). Metastatic liver sickness is more probable in the event that you've recently gotten chemotherapy or a growth [3]. In the extraordinary larger part of patients, it is feasible to utilize the bene ts of imaging modalities to show up at a precise determination (1.0 cm sores are for the most part harmless) [4]. The presence or nonattendance of cirrhosis in liver masses ought not entirely settle for demonstrative purposes [5]. A hepatic mass in a cirrhotic liver ought to be thought to be HCC except if generally illustrated. In cirrhotic livers, numerous liver masses might be an indication of broad The results of the present study therefore concluded that CT is a useful modality for the diagnosis of malignant liver masses.Ultrasound had high sensitivity, speci city for the hepatic masses. females were more effected than males. Among hepatic masses, HCC is the commonest. number of patients were 261 out of which 124 patients were female and 137 were male. Minimum age limit for female suffering from the disease were 15 while maximum age for female were 95 the mean value was 57.7. SD ratio ± 17.65. On other hand the minimum age for male were 23 and maximum age was 96 comparatively more than female. The mean value for male were ± 60.8SD ratio for male were 14.0. However, the SD ratio of female is more as compared to male which shows that the disease rate in female is more as compared to male, Table 1.

A R T I C L E I N F O A B S T R A C T
Diagnostic Accuracy of Ultrasound for as Gold Standard

M E T H O D S
HCC, high-level dysplastic knobs, or, in very uncommon conditions, hepatic lymphoma. Various hepatic sores are habitually an indication of liver metastases in a sound liver (most regularly from adenocarcinoma of the colon, stomach, lung, or liver) [6]. The liver, which makes around 2 % to 3 % of the general weight, is the greatest organ [7]. The liver is partitioned into two curves, which are generally depicted utilizing two distinct physical classes: morphologic life systems and useful life structures [8]. It is upheld by the ribcage and is held set up by peritoneal re ections known as ligamentous connections in the right upper quadrant of the stomach cavity under the right hemidiaphragm [9]. These connections are internal and associate with the Glisson case, the liver's adaptation of the instinctive peritoneum, regardless of not being genuine ligaments [10]. The use of contrast enhanced computed tomography for this purpose is supported by different previous studies that contrast enhanced computed tomography had an excellent diagnostic modality for the differentiation of different hepatic masses. The point of this study was to gure out the analytic exactness of ultrasound in diagnosis of hepatic masses taking computed tomography as gold standard. And, it will also help the patient to save his pocket rather than visit to other expensive modalities for the purpose of treatment and evaluation of hepatic lesions. This is a cross sectional review used to assess diagnostic accuracy of ultrasound in diagnosis of hepatic masses taking computed tomography as gold standard. This is a cross sectional review study was carried out in the Department of Radiology THQ Hospital Hazro, sample size was Two hundred sixty-six patients of age group 45 to 65 years were included in this study. The inclusion criteria for data collection were patients with HCC of both genders. The exclusion criteria were patient allergic to contrast, pregnant women, any patient with renal problem which was con rmed after creatinine test. Patients was educated about the nature, objective of the review, and composed informed assent was taken, and Institutional Morals Advisory group endorsement was taken ahead of time evaluate diagnostic accuracy of ultrasound in diagnosis of hepatic masses taking 64 -slices computed tomography machine. For the analysis of data, and percentages of qualitative data and quantitative data mean standard deviation was derived. Sensitivity, speci city, PPV and NPV reported to nd out the accuracy of ultrasound in hepatic masses. Consecutive sampling method was used. The collection of data were done through questionnaire and analysis by using SPSS version 25.0.

R E S U L T S
In all, 261 patients were enrolled in this trial.   The frequencies of hepatic masses are shown in Figure 1.    The diagonal segments are produced by ties The table 4 describes the HCC frequency (90%) higher than hemangioma (6.1%) and adenoma (3.8%).  The ultrasound image of Hepatocellular carcinoma with vascularized hyperechoic mass is shown in gure 3. Figure  4 showed CT scan result of Hepatocellular carcinoma in the right lobe of liver. Liver masses are getting more common among people when diagnosed with the imaging technology especially for the identi cation of abdominal conditions. Such liver masses can be benign or malignant depending on the diagnoses and identi cation for providing a speci c patient care. Several imaging technologies can be used to identify liver or hepatic masses without any invasive techniques and diagnostic measures. According to study hepatic masses are more likely to be found in male as compared to female. The study showed that male to female ratio was 4:1. Additionally, it also described that HCC was more common between the 40 to 70 years of age [11][12][13][14]. According to our study in table 1 the male patients were more likely to have HCC when compared with females. Out of 261 patients 124 patients were female while males were 137. Our study also described that the age frequency was between 45 to 65. According to Jones et al., research described the risk factors and initial liver cancer in a study of more the 5 billion people [15]. The mean SD ratio for men were 11.1 with the age 43.9 years while for females the SD ratio was 12.3 with the age 44.1 years. This shows that females SD ratio was more when compared with male. According to our study the SD ratio for female were 17.6 while for male the SD ratio was 14.0. The results showed that the SD ratio of female with liver mass is more as compared to male. According to another study showed that out of 385 patients, 65 patients were having HCC (6.1%) which were benign and having hemangioma. Schwartz et al., study showed that not all HCC patents are having hemangioma, but it is also not necessary that HCC patients do not have hemangioma [16]. According to our study the frequency of HCC is more as compared to hemangioma and adenoma. The frequency of HCC is 90%, hemangioma is 6.1 and adenoma is 3.8%. Frequency of hemangioma is more than adenoma but less then HCC. Frequency of adenoma is  This research has certain drawbacks. One of the drawbacks was that there were not enough patients in each of the three types of lesions. This is why we couldn't calculate ultrasound accuracy for each lesion separately.

CT Diagnosis Frequency
The results of the present study therefore concluded that CT is a useful modality for the diagnosis of malignant liver masses Ultrasound had high sensitivity, speci city for the hepatic masses. females were more effected than males. Among hepatic masses, HCC is the commonest.

C O N C L U S I O N S
The authors declare no con ict of interest