Differential Diagnosis between Benign and Malignant Bowel Lesions on Ultrasonogram and CT

Suh, Chan Hae; Kim, Mi Young

Journal of Korean Society of Medical Ultrasound 1996;15(1): 35-42.

Department of Diagnostic Radiology, Inha University Hospital

ABSTRACT

PURPOSE : To evaluate the diagnostic criteria for differentiation between benign and malignant bowel walllesions on ultrasonogram (US) and CT. MATERIAL & METHODS : We prospectively analyzed 55 bowel lesions on US andCT, including 29 cases of benign lesion and 26 cases of malignant lesion. The thickness and length of the lesionswere measured and the bowel features were classified into four categories : a) obliteration of bowel wall layers,b) marginal irregularity, c)eccentric wall thickening, and d) heterogeneous perilesional fat changes. We analyzedthe sensitivity, specificity, positive and negative predictive values of each criterion. RESULTS : The meanthickness of malignant bovel lesions was 1.77 / 1.84 cm on US/CT, and that of benign lesions was 0.71 / 0.80 cm onUS/CT. There was statistically significant difference in thickness between benign and malignant lesions (P<.05).The statistical anaysis of incremental study showed that the most sensitive and specific criteria for malignantlesions were more than 1.2cm in thickness and less than 5.0cm in length. Among feature criteria, bowel wallobliteration, irregular margin and eccentric contour were statistically and significantly different between benignand malignant lesions (P<.05). The most sensitive and specific feature criterion was the bowel wall obliteration.CONCLUSION : The most sensitive and specific criteria for differentiation between benign and malignant bowellesions were thickness and obliteration of bowel wall layers. Particulary, US was useful for the detection ofbowel wall layers.

Keywords: Benign. Malignant bowel lesions, Ultrasonogram. CT