Tidebrant G, Hafström L O, Tylén U
Department of Radiology, Sahlgrenska Sjukhuset, University of Gothenburg, Sweden.
Acta Radiol. 1989 Jul-Aug;30(4):395-9.
Preoperative radiologic examinations were reviewed in 110 patients planned for liver resection. Forty-five patients had a CT examination within a month before the operation; 22 of these also had ultrasonography (US) and 38 had angiography. In a numeric analysis of lesions, true positive findings were observed at CT and US in 69 per cent and 61 per cent, respectively. Angiography, mainly performed to show the vascular anatomy and patency of the portal vein and not to optimize tumour detection, showed 55 per cent of the lesions. Attempts were made to predict resection size with CT by estimating intrahepatic tumour extent. CT showed correct tumour extent in 73 per cent but was inaccurate in 12 of 45 examinations. In 5 of these, tumour growth across the main and sagittal fissures was misinterpreted, with both under- and overestimations. Improvements of current imaging methods are needed to make the radiologic assessment prior to liver surgery more reliable.
对计划进行肝切除术的110例患者的术前放射学检查进行了回顾。45例患者在手术前一个月内进行了CT检查；其中22例还进行了超声检查（US），38例进行了血管造影。在病变的数值分析中，CT和US的真阳性发现率分别为69%和61%。血管造影主要用于显示门静脉的血管解剖结构和通畅情况，而非优化肿瘤检测，显示出55%的病变。尝试通过估计肝内肿瘤范围用CT预测切除大小。CT显示正确的肿瘤范围占73%，但在45例检查中有12例不准确。其中5例中，肿瘤跨越主裂和矢状裂的生长被错误解读，既有低估也有高估。需要改进当前的成像方法，以使肝手术前的放射学评估更可靠。
