Detection of liver metastases from colorectal carcinoma: is there a place for routine computed tomography arteriography?
Detection of liver metastases from colorectal carcinoma: is there a place for routine computed tomography arteriography?
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结直肠癌肝转移的检测：是否有常规计算机断层扫描动脉造影的一席之地？
DOI：
10.1016/s0039-6060(96)80259-5
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发表时间：
1996
期刊：
影响因子：
3.8
通讯作者：
Theo Wiggers
中科院分区：
文献类型：
--
作者：
Bart van Ooijen;Matthijs Oudkerd;Paul I. M. Schmitz;Theo Wiggers
BackgroundA前瞻性评估肝脏术前超声，常规计算机断层扫描（CT），连续CT血管造影（CCTA）进行了60例原发性或继发性大肠癌。MethodsThe参考标准是触诊的肝脏和术中超声。影像学技术进行了评估，独立于each other.ResultsIn 37例患者105肝转移瘤被确定; 23例患者没有转移。与超声检查（48%）和传统CT（52%）相比，CCTA的灵敏度高达94%（识别出99个病变）。CCTA在直径小于1cm的病变中也表现出优越性。然而，高灵敏度伴随着高假阳性率，特别是因为正常肝实质灌注的变化。总的来说，CCTA的准确性最高（74%），超声和CT（均为57%）。这些数据表明，术前超声检查和常规CT在检测肝转移瘤的敏感性较低。结论CCTA虽然似乎是上级其他术前影像学技术，太低的特异性将妨碍其常规应用于结直肠癌肝转移患者。
BackgroundA prospective evaluation of the liver by preoperative ultrasonography, conventional computed tomography (CT), and continuous CT angiography (CCTA) was performed in 60 patients with primary or secondary colorectal carcinoma.MethodsThe standards of reference were palpation of the liver and intraoperative ultrasonography. The imaging techniques were assessed independently of each other.ResultsIn 37 patients 105 liver metastases were identified; 23 patients had no metastases. CCTA had a high sensitivity of 94% (99 lesions identified) in contrast to ultrasonography (48%) and conventional CT (52%). The superiority of CCTA was also manifest in lesions less than 1 cm in diameter. However, the high sensitivity was accompanied by a high false-positive rate, particularly because of variations in the perfusion of normal liver parenchyma. Overall, CCTA had the highest accuracy (74%) compared with ultrasonography and CT (both 57%). The data indicate that preoperative ultrasonography and conventional CT have low sensitivity in the detection of liver metastases.ConclusionsAlthough CCTA seems to be superior to other preoperative imaging techniques, the too low specificity will hamper its routine application in patients with hepatic metastases from colorectal carcinoma.