OBJECTIVE: The purpose of this study was to determine the diagnostic value of the sonographic halo sign (defined as any hypoechoic rim in the periphery of a lesion) in distinguishing between benign and malignant isoechoic and hyperechoic liver lesions on sonography. MATERIALS AND METHODS: Sonograms of the liver in 50 patients with proved benign liver tumors and in 50 patients with proved malignant liver tumors (seven primary liver neoplasms, 43 metastases) selected during a 13-month period were retrospectively analyzed by four radiologists who had no knowledge of the patients' clinical findings or the final diagnoses. Only a single sonogram was studied in each case. The presence or absence of a hypoechoic halo on the sonogram was the only criterion for distinguishing malignant from benign hepatic lesions. RESULTS: For 95 of 100 hepatic lesions, the four radiologists were almost (three vs one) or completely (four vs zero) in agreement about the presence or absence of a hypoechoic halo. In the five cases where there were conflicting decisions (two vs two), a final decision (four vs zero) was achieved by reviewing the entire series of sonographic images. A halo could be detected in 44 malignant tumors (88%) and in only seven benign tumors (14%) (sensitivity, 88%; specificity, 86%; positive and negative predictive values, 86% and 88%, respectively). The sonographic halo sign was particularly helpful in distinguishing hemangiomas (n = 29) from metastases (n = 43) (positive and negative predictive values, 95% and 87%, respectively). CONCLUSION: The results of this study suggest that the halo sign on sonograms is useful to distinguish benign from malignant isoechoic or hyperechoic tumors.
OBJECTIVE: The purpose of this study was to determine the diagnostic value of the sonographic halo sign (defined as any hypoechoic rim in the periphery of a lesion) in distinguishing between benign and malignant isoechoic and hyperechoic liver lesions on sonography. MATERIALS AND METHODS: Sonograms of the liver in 50 patients with proved benign liver tumors and in 50 patients with proved malignant liver tumors (seven primary liver neoplasms, 43 metastases) selected during a 13-month period were retrospectively analyzed by four radiologists who had no knowledge of the patients' clinical findings or the final diagnoses. Only a single sonogram was studied in each case. The presence or absence of a hypoechoic halo on the sonogram was the only criterion for distinguishing malignant from benign hepatic lesions. RESULTS: For 95 of 100 hepatic lesions, the four radiologists were almost (three vs one) or completely (four vs zero) in agreement about the presence or absence of a hypoechoic halo. In the five cases where there were conflicting decisions (two vs two), a final decision (four vs zero) was achieved by reviewing the entire series of sonographic images. A halo could be detected in 44 malignant tumors (88%) and in only seven benign tumors (14%) (sensitivity, 88%; specificity, 86%; positive and negative predictive values, 86% and 88%, respectively). The sonographic halo sign was particularly helpful in distinguishing hemangiomas (n = 29) from metastases (n = 43) (positive and negative predictive values, 95% and 87%, respectively). CONCLUSION: The results of this study suggest that the halo sign on sonograms is useful to distinguish benign from malignant isoechoic or hyperechoic tumors.
Authors: Wolfgang Kratzer; Beate Gruener; Tanja E M Kaltenbach; Sarina Ansari-Bitzenberger; Peter Kern; Michael Fuchs; Richard A Mason; Thomas F E Barth; Mark M Haenle; Andreas Hillenbrand; Suemeyra Oeztuerk; Tilmann Graeter Journal: World J Gastroenterol Date: 2015-11-21 Impact factor: 5.742