Konopke R, Kersting S, Bergert H, Bloomenthal A, Gastmeier J, Saeger H D, Bunk A
Department of Visceral, Thoracic and Vascular Surgery, Carl Gustav Carus University Hospital, University of Technology, Fetscherstr. 74, 01307 Dresden, Germany.
Int J Colorectal Dis. 2007 Feb;22(2):201-7. doi: 10.1007/s00384-006-0134-5. Epub 2006 May 30.
BACKGROUND/AIMS: The advent of contrast-enhanced ultrasound (CEUS) has called into question the efficacy of standard ultrasonographic techniques. In this study, we evaluated B-mode and color-duplex imaging and CEUS in the detection of liver metastases, using intraoperative and histological findings as a reference.
Before laparotomy, 108 patients suspected of having liver metastases were prospectively examined with B-mode and color-duplex imaging, followed by contrast-enhanced ultrasound (2.4 ml SonoVue). Patients with unresectable tumors (n=8) were excluded from the analysis. The sonographic diagnosis in the remaining 100 patients was compared to the intraoperative and histological findings.
RESULTS/FINDINGS: CEUS improved the sensitivity for detecting liver lesions from 56.3% (B-mode) to 83.8% (CEUS) (p=0.004). In particular, the contrast agent led to an improvement in ultrasonographic detection in the following cases: nodular metastases smaller than one centimeter; after adjuvant chemotherapy; for tumors near the surface of the liver; and for lesions situated around the ligamentum teres.
INTERPRETATION/CONCLUSIONS: CEUS provides significant improvement in the detection of liver metastases, and should therefore, be performed routinely in the surveillance of cancer patients.
背景/目的：超声造影（CEUS）的出现使标准超声技术的有效性受到质疑。在本研究中，我们以术中及组织学检查结果为参照，评估了B超、彩色双功成像及CEUS在检测肝转移瘤方面的效果。
在开腹手术前，对108例疑似肝转移瘤的患者进行前瞻性研究，先采用B超和彩色双功成像检查，随后进行超声造影（2.4ml声诺维）。分析时排除了8例无法切除肿瘤的患者。将其余100例患者的超声诊断结果与术中及组织学检查结果进行比较。
结果/发现：CEUS将肝损伤检测的敏感度从56.3%（B超）提高到83.8%（CEUS）（p = 0.004）。特别是，造影剂在以下情况中提高了超声检测效果：直径小于1厘米的结节状转移瘤；辅助化疗后；靠近肝脏表面的肿瘤；以及位于肝圆韧带周围的损伤。
解读/结论：CEUS在肝转移瘤检测方面有显著改善，因此应在癌症患者监测中常规应用。
