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

Yi Dong; Wen-Ping Wang; Andre Ignee; Dan Zuo; Yi-Jie Qiu; Qi Zhang; Xiu-Yun Lu; Sheng Chen; Christoph Frank Dietrich

doi:10.15557/jou.2023.0010

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

J Ultrason. 2023 May 11;23(93):e45-e52. doi: 10.15557/jou.2023.0010. eCollection 2023 Jun.

Authors

Yi Dong¹, Wen-Ping Wang², Andre Ignee³, Dan Zuo², Yi-Jie Qiu², Qi Zhang², Xiu-Yun Lu², Sheng Chen², Christoph Frank Dietrich⁴

Affiliations

¹ Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.
² Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China.
³ Department of Gastroenterology and Rheumatology, Julius-Spital Würzburg, Würzburg, Germany.
⁴ Department General Internal Medicine, Hirslanden Clinics Beau-Site, Salem and Permancence, Bern, Switzerland.

Abstract

Aim: To investigate the diagnostic value of resistance index (RI) in differentiating focal liver lesions.

Patients and methods: In this retrospective study, a total of 576 patients with histologically confirmed focal liver lesions were included. Each patient underwent B-mode ultrasound examination and color Doppler ultrasound examination. The RI values of different focal liver lesions were recorded and compared.

Results: The mean RI value of benign lesions was significantly lower than that of malignant lesions (0.54 ± 0.10 vs. 0.71 ± 0.12) (p <0.05). In malignant lesions, the RI value of intrahepatic cholangiocarcinoma was significantly lower than that of hepatocellular carcinoma lesions. Furthermore, in hepatocellular carcinoma lesions, the RI of large lesions (group 4: >10 cm) was significantly lower than that of small lesions (group 1: ≤2 cm, group 2: 2-5 cm) (p <0.05). Taken RI of 0.615 as a cutoff value to differentiate malignant and benign lesions, the sensitivity, specificity, positive predictive value and negative predictive value were 82.80%, 81.00%, 81.34% and 82.48%, respectively.

Conclusion: Color Doppler ultrasound examination is a valuable imaging method in detecting blood flow signal within liver lesions. The RI parameter should be helpful in differentiating malignant and benign liver tumors.

Keywords: B-mode ultrasound (BMUS); focal liver lesion (FLL); focal nodular hyperplasia (FNH); hepatocellular carcinoma (HCC); resistance index (RI).