Malone D E, McGrath F P
Department of Radiology, Faculty of Health Sciences, McMaster University, Hamilton, Ont.
Can Assoc Radiol J. 1993 Feb;44(1):5-13.
Colorectal metastases in the liver are common. In appropriately selected patients resection can increase the 5-year survival rate from 0% to 33%. When consulted by their surgery colleagues about patient selection, radiologists now have a wide choice of imaging methods, including nuclear medicine, ultrasonography, unenhanced computed tomography (CT), intravenously enhanced CT (by infusion or by the dynamic and delayed methods), arterially enhanced CT (specifically, CT arterial portography and CT angiography) and magnetic resonance imaging. In Canada this wide range of techniques has appeared in an era of cost constraint. This article discusses the surgical background for imaging colorectal metastases in the liver and reviews the available imaging methods. The authors present an algorithmic approach that attempts to balance the need for accuracy with the logistic and financial constraints under which radiologists work in Canada. They suggest that this algorithm would allow optimal use of available resources in most Canadian hospitals.
肝脏中的结直肠转移瘤很常见。在经过适当选择的患者中，手术切除可将5年生存率从0%提高到33%。当外科同事就患者选择问题向放射科医生咨询时，放射科医生现在有多种成像方法可供选择，包括核医学、超声检查、平扫计算机断层扫描（CT）、静脉增强CT（通过静脉滴注或动态及延迟方法）、动脉增强CT（特别是CT动脉门静脉造影和CT血管造影）以及磁共振成像。在加拿大，这一系列广泛的技术出现在成本受限的时代。本文讨论了对肝脏结直肠转移瘤进行成像的手术背景，并回顾了现有的成像方法。作者提出了一种算法方法，试图在准确性需求与放射科医生在加拿大工作所面临的后勤和财务限制之间取得平衡。他们认为，这种算法将使加拿大大多数医院能够最佳地利用现有资源。
