Schacherer D, Decking D, Herold T, Obed A, Schlitt H-J, Gruene S, Schoelmerich J, Schlottmann K
Klinik und Poliklinik für Innere Medizin I, Universität Regensburg, Germany.
Z Gastroenterol. 2010 Feb;48(2):241-5. doi: 10.1055/s-0028-1109711. Epub 2010 Feb 2.
The localisation of focal liver lesions is usually performed according to the Couinaud classification system. The exact description of localisation and size of liver lesions is especially important for surgical procedures. The aim of this prospective study was the evaluation of differences and agreements in the localisation and size of hepatic lesions as found by ultrasound (US), computed tomography (CT) and according to the intraoperative status (OP).
32 patients (21 male, 11 female) were enrolled in the study. The results obtained from sonography, computed tomography and surgery were classified into 5 categories for localisation and for size, respectively.
According to the agreement between sonography and computed tomography, 25 % of all hepatic lesions were classified into category 1 (exact agreement), whereas 40.6 % were ranked into category 2 (almost exact agreement). Correlating sonography and intraoperative results, 31.3 % of the lesions were classified into category 1 and 46.9 % into category 2. In the comparison of CT with OP, 34.4 % of the lesions were found to be in category 1 and 43.8 % in category 2. Concerning the size of the lesions, almost half of the tumours (46.9 %) were classified into category 1 on the basis of the correlation between US and CT and 21.9 % on the basis of the correlation between US and OP.
The localisation and description of the size of hepatic lesions is mainly similar or even identical on the basis of the different methods. Further improvements might be achieved by the introduction of a consistent nomenclature.
局灶性肝病变的定位通常依据库尼亚德分类系统进行。肝病变定位和大小的准确描述对于外科手术尤为重要。这项前瞻性研究的目的是评估超声（US）、计算机断层扫描（CT）以及术中情况（OP）所发现的肝病变在定位和大小方面的差异与一致性。
32例患者（21例男性，11例女性）纳入本研究。将超声检查、计算机断层扫描及手术所得结果分别按定位和大小分为5类。
根据超声与计算机断层扫描之间的一致性，所有肝病变中有25%被归类为1类（完全一致），而40.6%被归类为2类（几乎完全一致）。超声与术中结果相关分析时，31.3%的病变被归类为1类，46.9%被归类为2类。CT与OP比较时，34.4%的病变被发现属于1类，43.8%属于2类。关于病变大小，基于US与CT的相关性，几乎一半的肿瘤（46.9%）被归类为1类，基于US与OP的相关性则为21.9%。
基于不同方法，肝病变的定位及大小描述主要相似甚至相同。引入一致的命名法可能会进一步改善。
