CORRELATION AMONG CLINICAL INDICATIONS, IMAGING PATTERNS AND HISTOPATHOLOGY OF LIVER LESIONS IN PATIENTS REFERRED FOR ULTRASOUND GUIDED LIVER BIOPSIES AT MOI TEACHING AND REFERRAL HOSPITAL (MTRH), KENYA. (original) (raw)
Background: Liver biopsy is a core investigation tool in the evaluation and subsequent management of patients with liver neoplasms or inflammatory conditions. Liver biopsy is useful in making diagnosis, assessing the prognosis of liver diseases and in making decisions for therapeutic management. Interventional radiology is a rapidly growing subspecialty, with very few personnel generally, more so in developing countries. Ultrasound guided percutaneous liver biopsy is currently being done in only two public facilities in Kenya. This study evaluated the clinical indications, imaging and histopathological diagnosis of liver diseases observed in our setting from ultrasound guided liver biopsies. Objectives: To describe the clinical indications, imaging patterns and histopathological diagnoses of liver diseases diagnosed by ultrasound guided liver biopsies at Moi Teaching and Referral Hospital. Methods: This was a cross sectional study done at the Moi Teaching and Referral Hospital (MTRH) in Kenya, in the departments of Radiology &Imaging and Histopathology. All consenting patients referred for ultrasound guided liver biopsy were studied with a sample size of 36 patients, over one year period. Data was collected prospectively from the patients. A structured data entry form was used to gather all the information. Data was analyzed using descriptive statistics with the aid of STATA version 12 special edition. The test for agreement between two raters was done using Kappa test. Results: The working clinical diagnosis from the referring clinician showed that 22(63%) participants had hepatocellular carcinoma (HCC), 1(3%) had hydatid, 1(3%) had an incidental finding, 3(9%) had lymphoma, 1(3%) and 7(20%) had metastasis. On the histopathology results, HCCwas the commonest pathology that was diagnosed (n=21). Most HCC lesions were larger than 5cm (n=18, 90%) and 85% of these lesions were heterogeneous on sonography. There was a moderately strong kappa value (kappa=0.511) for the level of agreement between sonographic and histological diagnosis of liver cancer. The only complication was pain (n=21, 60%).
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