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结直肠肝转移的术前影像学:放射科医生和多学科团队需要了解的内容。

Preoperative imaging of colorectal liver metastases: what the radiologist and the multidisciplinary team need to know.

机构信息

Department of Radiology, Mater Misericordiae University Hospital, Dublin D07, Ireland.

出版信息

Br J Radiol. 2024 Oct 1;97(1162):1602-1618. doi: 10.1093/bjr/tqae133.

Abstract

The management of patients with colorectal liver metastases (CRLM) has transformed over the past 2 decades. Advances in surgical techniques, systemic therapies, and local treatments have resulted in a paradigm shift. Disease that would once have been considered terminal is now frequently treated aggressively with both a disease-free and overall survival benefit. In line with the expanding range of treatment options, there has been an increase in the volume and complexity of imaging required in the management of these patients to ensure optimal patient selection and outcome. The radiologist plays a pivotal role in interpreting these studies, conveying the relevant information and informing the discussion at multidisciplinary team meetings. The purpose of this review is to provide an update for radiologists on the current surgical management of patients with CRLM highlighting specific imaging information that is required by the multidisciplinary team when assessing resectability and/or the need for additional liver-directed therapies.

摘要

过去 20 年来,结直肠肝转移(CRLM)患者的管理发生了重大变化。手术技术、全身治疗和局部治疗的进步带来了范式转变。曾经被认为是绝症的疾病现在经常通过无疾病和总体生存获益来积极治疗。与治疗选择范围的扩大相一致,在这些患者的管理中需要进行更多和更复杂的影像学检查,以确保患者选择和结果的最优化。放射科医生在解释这些研究中起着关键作用,传递相关信息,并为多学科团队会议提供讨论依据。本文旨在为放射科医生提供 CRLM 患者当前手术管理的最新信息,重点介绍多学科团队在评估可切除性和/或是否需要额外的肝定向治疗时所需的特定影像学信息。

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