Nakano Hiroshi, Ishida Yasuo, Hatakeyama Toshiyuki, Sakuraba Kazuma, Hayashi Masahiro, Sakurai Osamu, Hataya Kiyoshi
Department of Surgery, Yokohama Asahi-Chuo General Hospital, 4-20-1 Wakabadai, Asahi-ku, Yokohama 241-0801, Japan.
World J Gastroenterol. 2008 May 28;14(20):3207-11. doi: 10.3748/wjg.14.3207.
To find occult metastases during hepatectomy in patients with colorectal cancer liver metastases (CRCLM), contrast-enhanced intraoperative ultrasonography (CE-IOUS) was performed using a new microbubble agent, sonazoid, which provides a parenchyma-specific contrast image based on its accumulation in the Kupffer cells.
Eight patients with CRCLM underwent CE-IOUS using sonazoid before hepatectomy. The liver was investigated during a late Kupffer-phase imaging, which is a valuable characteristic of sonazoid.
CE-IOUS using sonazoid provided the early vascular- and sinusoidal-phase images for 10 min followed by the late Kupffer-phase image up to 30 min after the injection of sonazoid. IOUS did not provide new findings of metastatic lesion in the 8 patients. However, during the late Kupffer-phase image of sonazoid, a metastatic lesion was newly found in two of the 8 patients. These newly detected lesions were removed by an additional hepatectomy and histopathologically diagnosed as a metastasis.
CE-IOUS using sonazoid can allow surgeons to investigate the whole liver with enough time and to find new metastases intraoperatively.
为了在结直肠癌肝转移（CRCLM）患者肝切除术中发现隐匿性转移灶，使用一种新型微泡剂声诺维进行术中超声造影（CE - IOUS），该微泡剂基于其在库普弗细胞中的积聚提供实质特异性造影图像。
8例CRCLM患者在肝切除术前使用声诺维进行CE - IOUS。在库普弗细胞晚期成像期间对肝脏进行检查，这是声诺维的一个重要特征。
使用声诺维的CE - IOUS在注射声诺维后10分钟内提供早期血管和窦状隙期图像，随后在30分钟内提供晚期库普弗期图像。IOUS在这8例患者中未发现转移灶的新情况。然而，在声诺维的晚期库普弗期图像中，8例患者中有2例新发现了转移灶。这些新检测到的病灶通过额外的肝切除术切除，并经组织病理学诊断为转移灶。
使用声诺维的CE - IOUS可使外科医生有足够时间对整个肝脏进行检查，并在术中发现新的转移灶。
