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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.

DOI:10.3748/wjg.v16.i4.508
PMID:20101780
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2811807/
Abstract

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.

摘要

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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Reply to "Application of contrast-enhanced intraoperative ultrasonography in the decision-making about hepatocellular carcinoma operation".回复“术中增强超声造影在肝细胞癌手术决策中的应用”一文的质疑。
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World J Gastroenterol. 2008 Jul 7;14(25):4005-10. doi: 10.3748/wjg.14.4005.
2
Intraoperative ultrasonography during planned liver resections remains an important surgical tool.在计划性肝切除术中,术中超声检查仍然是一项重要的手术工具。
Surg Endosc. 2008 Apr;22(4):1137-8. doi: 10.1007/s00464-008-9797-z. Epub 2008 Feb 23.
3
Use of second generation contrast-enhanced ultrasound in the assessment of focal liver lesions.第二代超声造影在肝脏局灶性病变评估中的应用
World J Gastroenterol. 2007 Dec 7;13(45):5963-70. doi: 10.3748/wjg.v13.45.5963.
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Characterization of hypoechoic focal hepatic lesions in patients with fatty liver: diagnostic performance and confidence of contrast-enhanced ultrasound.脂肪肝患者肝脏低回声局灶性病变的特征:超声造影的诊断效能及可信度
Eur Radiol. 2007 Mar;17(3):650-61. doi: 10.1007/s00330-006-0432-x. Epub 2006 Oct 3.
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Intraoperative US of the liver: techniques and clinical applications.肝脏术中超声:技术与临床应用
Radiographics. 2006 Jul-Aug;26(4):1067-84. doi: 10.1148/rg.264055120.
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Radiographics. 2004 Jul-Aug;24(4):921-35. doi: 10.1148/rg.244035158.
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