增强型术中超声在肝细胞癌手术决策中的应用。
Application of contrast-enhanced intraoperative ultrasonography in the decision-making about hepatocellular carcinoma operation.
机构信息
Department of Hepato-Biliary-Pancreatic surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
出版信息
World J Gastroenterol. 2010 Jan 28;16(4):508-12. doi: 10.3748/wjg.v16.i4.508.
AIM
To evaluate the detection and differentiation ability of contrast-enhanced intraoperative ultrasonography (CE-IOUS) in hepatocellular carcinoma (HCC) operations.
METHODS
Clinical data of 50 HCC patients were retrospective analyzed. The sensitivity, specificity, false negative and false positive rates of contrast enhanced magnetic resonance imaging (CE-MRI), IOUS and CE-IOUS were calculated and compared. Surgical strategy changes due to CE-IOUS were analyzed.
RESULTS
Lesions detected by CE-MRI, IOUS and CE-IOUS were 60, 97 and 85 respectively. The sensitivity, specificity, false negative rate, false positive rate of CE-MRI were 98.2%, 98.6%, 98.6%, 60.0%, respectively; for IOUS were 50.0%, 90.9%, 1.8%, 1.4%, respectively; and for CE-IOUS were 1.4%, 40.0%, 50.0%, 9.1%, respectively. The operation strategy of 9 (9/50, 18.0%) cases was changed according to the results of CE-IOUS.
CONCLUSION
Compared with CE-MRI, CE-IOUS performs better in detection and differentiation of small metastasis and regenerative nodules. It plays an important role in the decision-making of HCC operation.
目的
评估术中超声造影（CE-IOUS）在肝细胞癌（HCC）手术中的检测和鉴别能力。
方法
回顾性分析 50 例 HCC 患者的临床资料。计算并比较增强磁共振成像（CE-MRI）、IOUS 和 CE-IOUS 的敏感性、特异性、假阴性率和假阳性率。分析因 CE-IOUS 而改变的手术策略。
结果
CE-MRI、IOUS 和 CE-IOUS 检测到的病灶分别为 60、97 和 85 个。CE-MRI 的敏感性、特异性、假阴性率、假阳性率分别为 98.2%、98.6%、98.6%、60.0%；IOUS 分别为 50.0%、90.9%、1.8%、1.4%；CE-IOUS 分别为 1.4%、40.0%、50.0%、9.1%。根据 CE-IOUS 的结果，9 例（9/50，18.0%）患者的手术策略发生了改变。
结论
与 CE-MRI 相比，CE-IOUS 在检测和鉴别小转移灶和再生结节方面表现更好。它在 HCC 手术的决策中起着重要作用。
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