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葡萄膜黑色素瘤诊断时腹部计算机断层扫描发现的肝脏异常。

Hepatic abnormalities identified on abdominal computed tomography at diagnosis of uveal melanoma.

作者信息

Feinstein Eric G, Marr Brian P, Winston Corinne B, Abramson David H

机构信息

University of Virginia School of Medicine, Charlottesville, VA, USA.

出版信息

Arch Ophthalmol. 2010 Mar;128(3):319-23. doi: 10.1001/archophthalmol.2009.401.

Abstract

OBJECTIVE

To determine the prevalence of hepatic abnormalities identified during abdominal computed tomography (CT) performed within 1 month of the diagnosis of primary uveal melanoma.

METHODS

Retrospective review of CT reports generated within 1 month following diagnosis of uveal melanoma in 91 patients at Memorial Sloan-Kettering Cancer Center, New York, New York, from 2004 to 2009.

RESULTS

Of 198 patients reviewed, 91 (46%) had a CT scan within 1 month of uveal melanoma diagnosis; 1 or more hepatic abnormalities were identified in 50 of these patients (55%). Abnormalities included 38 focal (13 solitary, 25 multiple) and 15 diffuse (11 partial, 4 complete) lesions. Six patients had hepatic lesions suspected to be metastatic melanoma, but this was confirmed in only 3. Lesions suspected to be metastases were more likely multiple than solitary (P = .03). Thirty-nine patients had other lesions, most commonly lesions that were too small to be characterized, a fatty liver, and hepatic cysts. Lesions in 5 of 50 patients with abnormalities could not be classified. Neither the protocol (triphasic vs nontriphasic) nor the center where the scan was performed (Sloan-Kettering vs other) was significantly related to the likelihood of identifying hepatic abnormalities in a given patient (P = .46 and P = .1, respectively).

CONCLUSION

Although hepatic abnormalities were frequently identified in patients who underwent CT within 1 month of uveal melanoma diagnosis, metastatic disease was confirmed only in the setting of multiple lesions in only a minority of patients.

摘要

目的

确定在原发性葡萄膜黑色素瘤诊断后1个月内进行腹部计算机断层扫描(CT)时发现的肝脏异常的患病率。

方法

回顾性分析2004年至2009年纽约市纪念斯隆凯特琳癌症中心91例葡萄膜黑色素瘤患者在诊断后1个月内生成的CT报告。

结果

在198例接受评估的患者中,91例(46%)在葡萄膜黑色素瘤诊断后1个月内进行了CT扫描;其中50例(55%)发现1个或更多肝脏异常。异常包括38个局灶性病变(13个孤立性、25个多发性)和15个弥漫性病变(11个部分性、4个完全性)。6例患者肝脏病变疑似为转移性黑色素瘤,但仅3例得到证实。疑似转移的病变多发性多于孤立性(P = 0.03)。39例患者有其他病变,最常见的是太小无法定性的病变、脂肪肝和肝囊肿。50例有异常的患者中5例的病变无法分类。扫描方案(三相扫描与非三相扫描)和扫描进行的中心(斯隆凯特琳癌症中心与其他中心)均与特定患者发现肝脏异常的可能性无显著相关性(分别为P = 0.46和P = 0.1)。

结论

尽管在葡萄膜黑色素瘤诊断后1个月内接受CT检查的患者中经常发现肝脏异常,但仅在少数患者中,在多发性病变的情况下才确诊为转移性疾病。

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