Choti Michael A, Kaloma Fanta, de Oliveira Michelle L, Nour Samah, Garrett-Mayer Elizabeth S, Sheth Sheila, Pawlik Timothy M
Department of Surgery, Johns Hopkins Hospital, 600 N Wolfe St, Blalock 665, Baltimore, MD 22187-6681, USA.
Arch Surg. 2008 Jan;143(1):29-34; discussion 35. doi: 10.1001/archsurg.2007.5.
To determine the distribution of echogenicity (hypoechoic, isoechoic, or hyperechoic) and predominant intraoperative ultrasonography (IOUS) echogenic appearance of colorectal liver metastasis. The interpatient and intrapatient variability of tumor IOUS echogenicity was assessed.
Retrospective review of prospectively collected database.
Tertiary cancer center.
Between January 1998 and July 2001, 99 patients (194 tumors) underwent hepatic resection for colorectal metastases.
During surgery, IOUS of the liver was performed and the images were digitally recorded. Images were randomly coded, blindly reviewed, and scored for echogenicity and ultrasonographic appearance pattern.
The ultrasonographic appearance of the colorectal liver metastasis was hypoechoic in 52.0%, isoechoic in 35.7%, and hyperechoic in 12.3% of cases. Most colorectal liver metastases appeared homogeneous (50.8%). Less commonly, identified lesions were characterized by a target or "bull's-eye" appearance (20%) or contained calcifications (19%). Clinicopathologic characteristics, including patient age and sex, as well as tumor size, number, and location and presence of hepatic steatosis, did not correlate with tumor echogenicity or ultrasonographic appearance pattern (all P > .05). Lesions within patients were more similar in echogenicity than lesions between patients (P < .001). Similarly, intrapatient variability in appearance pattern was significantly less than the variability between patients (P = .002).
The ultrasonographic characteristics of hepatic metastases within patients were more similar than between patients. Such information is important because it suggests that, in patients with more than 1 metastasis, the echogenic appearance of an index lesion may predict the echogenic appearance of additional occult disease.
确定结直肠癌肝转移灶的回声性（低回声、等回声或高回声）分布及术中超声（IOUS）的主要回声表现。评估患者间和患者内肿瘤IOUS回声性的变异性。
对前瞻性收集的数据库进行回顾性分析。
三级癌症中心。
1998年1月至2001年7月期间，99例患者（194个肿瘤）因结直肠癌肝转移接受了肝切除术。
手术期间，对肝脏进行IOUS检查并对图像进行数字记录。图像随机编码，由盲法进行评估，并对回声性和超声表现模式进行评分。
结直肠癌肝转移灶的超声表现为低回声的占52.0%，等回声的占35.7%，高回声的占12.3%。大多数结直肠癌肝转移灶表现为均匀性（50.8%）。较少见的是，发现的病灶具有靶样或“靶心”样表现（20%）或含有钙化（19%）。临床病理特征，包括患者年龄、性别，以及肿瘤大小、数量、位置和肝脂肪变性的存在情况，与肿瘤回声性或超声表现模式均无相关性（所有P>.05）。患者体内的病灶在回声性上比不同患者之间的病灶更相似（P<.001）。同样，患者内表现模式的变异性明显小于患者间的变异性（P=.002）。
患者体内肝转移灶的超声特征比不同患者之间的更相似。此类信息很重要，因为这表明，在有多个转移灶的患者中，索引病灶的回声表现可能预测其他隐匿性疾病灶的回声表现。
