Is CT portography (CTAP) really useful in patients with liver tumors who undergo intraoperative ultrasonography (IOUS)?
Is CT portography (CTAP) really useful in patients with liver tumors who undergo intraoperative ultrasonography (IOUS)?
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CT 门脉造影 (CTAP) 对于接受术中超声检查 (IOUS) 的肝肿瘤患者真的有用吗？
DOI：
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发表时间：
1995
期刊：
影响因子：
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通讯作者：
B. Eisenberg
中科院分区：
文献类型：
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作者：
L. Fortunato;M. Clair;J. Hoffman;E. Sigurdson;E. Sauter;L. Barber;B. Eisenberg
目的是比较CT在动脉门静脉造影（CTAP）和术中超声（IOUS）在原发性或转移性肝肿瘤患者治疗中的作用；研究CTAP在这些患者开腹前确定可切除性的能力；并研究成像算法中CTAP的遗漏是否会导致可切除率降低。我们回顾了1990年1月至1993年12月间88例连续接受CTAP和/或IOUS治疗的原发性或转移性肝癌患者。30例患者同时有CTAP和欠条，行31次剖腹手术（I组）。比较两种方法检测肝脏肿瘤的敏感性。28例为肝转移灶，3例为肝细胞癌。包括I组在内的53例患者在开腹前接受了CTAP，并研究了CTAP在确定不可切除性方面的敏感性（II组）。35例患者（III组）仅有欠条，研究是否遗漏CTAP降低了可切除率。第一组经影像学检查、手术探查及病理检查共发现52例肝脏病变。CT、CTAP、IOUS和勘探的灵敏度分别为67%、65%、100%和75%。欠条检测肝脏肿瘤的敏感性高于其他方式（P < 0.001）。在7/31（23%）的病例中增加了新的信息。CTAP假阳性率为4/31（13%）。在一个病例（3%）中，假阳性结果会妨碍根治性切除。CTAP通过显示不可切除的疾病改变了4/53（7.5%）患者的治疗。（摘要删节250字）
The objectives were to compare the role of CT during arterial portography (CTAP) and intraoperative ultrasound (IOUS) in the management of patients with primary or metastatic liver tumors; to study the ability of CTAP to define resectability before laparotomy in these patients; and to study whether the omission of CTAP in the imaging algorithm resulted in a diminished resectability rate. Eighty-eight consecutive patients with primary or metastatic liver cancer who underwent CTAP and/or IOUS between January 1990 and December 1993 were reviewed. Thirty patients had both CTAP and IOUS and underwent 31 laparotomies (Group I). The sensitivity of these two tests to detect liver tumors was compared. Twenty-eight explorations were performed for hepatic metastases and three for hepatocellular carcinoma. Fifty-three patients, including those in group I, underwent CTAP before laparotomy and were studied to assess the sensitivity of CTAP in determining unresectability (Group II). Thirty-five patients (Group III) had IOUS only and were studied to determine whether the omission of CTAP decreased the resectability rate. In Group I, 52 hepatic lesions were found by a combination of imaging studies, operative exploration, and pathologic examination. The sensitivity of CT, CTAP, IOUS, and exploration were 67 per cent, 65 per cent, 100 per cent, and 75 per cent, respectively. IOUS was more sensitive than any other modality in detecting liver tumors (P < 0.001). It added new information in 7/31 cases (23%). The false positive rate of CTAP was 4/31 (13%). In one case (3%), a false positive result would have precluded a curative resection. CTAP changed management of 4/53 patients (7.5%) by showing unresectable disease.(ABSTRACT TRUNCATED AT 250 WORDS)