Leone A, Violino P, Ghirardo D, Fioranti L, Borrelli M, Scarrone A, Ambrogi C, Mosillo L, Segre D, Quaranta L, Ferro C
Servizio di Radiodiagnostica, Ospedale S. Croce, Cuneo.
Radiol Med. 1996 Jan-Feb;91(1-2):86-90.
This study was performed to confirm the high sensitivity of CT during arterial portography (CTAP) versus US and dynamic CT in the diagnosis of liver metastases from colorectal cancer. Ninety patients with 108 colorectal cancers underwent US, dynamic CT and CTAP to investigate the presence of liver metastases. US depicted 39 metastases in 26 patients, dynamic CT 46 metastases in 29 patients and CTAP 54 lesions in 34 patients. CTAP detected 8 metastases missed at dynamic CT; 4 of them were < 1 cm in diameter, 3 ranged 1-2 cm and one metastasis > 2 cm in diameter. After preoperative investigations only 7 patients were considered for hepatic resection. At surgery, palpation and intraoperative US of the liver detected two more metastases in the same patients. Our experience, in agreement with recent studies, confirms CTAP as the most sensitive preoperative method in detecting liver metastases and its superiority to be most apparent in lesions < 1 cm in diameter. Therefore, we consider CTAP an essential imaging technique for planning the correct treatment of liver metastases.
本研究旨在证实动脉门静脉造影CT（CTAP）相对于超声及动态CT在诊断结直肠癌肝转移方面具有更高的敏感性。90例患有108处结直肠癌的患者接受了超声、动态CT及CTAP检查以探究肝转移情况。超声显示26例患者有39处转移灶，动态CT显示29例患者有46处转移灶，CTAP显示34例患者有54处病灶。CTAP检测出动态CT漏诊的8处转移灶；其中4处直径小于1 cm，3处直径在1 - 2 cm之间，1处直径大于2 cm。术前检查后，仅7例患者被考虑行肝切除术。手术中，肝脏触诊及术中超声在相同患者中又检测出两处转移灶。我们的经验与近期研究一致，证实CTAP是检测肝转移最敏感的术前方法，且其优势在直径小于1 cm的病灶中最为明显。因此，我们认为CTAP是规划肝转移正确治疗方案必不可少的成像技术。
