Detection of hepatic metastases from colorectal carcinoma - Comparison of histopathologic features of anatomically resected liver with results of preoperative imaging
Detection of hepatic metastases from colorectal carcinoma - Comparison of histopathologic features of anatomically resected liver with results of preoperative imaging
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DOI：
10.1097/01.mcg.0000225676.22218.08
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发表时间：
2007-09-01
影响因子：
2.9
通讯作者：
Miyagawa, Shin-ichi
中科院分区：
文献类型：
--
作者：
Nomura, Kazuhiko;Kadoya, Masumi;Miyagawa, Shin-ichi
目标：静脉增强多层螺旋CT（MDCT）、超顺磁性氧化铁增强磁共振成像的特异性和敏感性（SPIO-MRI），多探测器行计算机断层扫描联合动脉门静脉造影与多探测器行计算机断层扫描联合肝动脉造影（CTAP/CTHA），和术中超声检查（IOUS）基于切除肝脏的组织病理学检查，对检测结直肠癌前肝转移进行了评价。常规行MDCT、SPIO-MRL CTAP/CTHA和IOUS检查，以确定结直肠癌肝转移患者的手术指征和方法。结果：8例结直肠癌肝转移患者，解剖切除大量肝脏，病理组织学检查共发现转移灶50个。肿瘤直径3 ~ 53 mm，平均13.8 mm，直径小于10 mm者26例（52%）。肝组织病理学检查显示CTAP/CTHA是最敏感的影像学检查方法，其次是IOUS、SPIO-MRI。MDCT。在CTAP/CTHA检出的所有肿瘤中，SPIO-MRI漏诊5例，而SPIO-MRI检出的所有肿瘤CTAP/CTHA均检出。MDCT、SPIO-MRI和组织病理学检查检测到的转移性肝肿瘤数量差异显著。IOUS检测到1个假阳性病灶。结论：CTAP/CTHA是检测结直肠癌小肝转移的一种有用的术前影像学检查方法。
Goals: The specificity and sensitivity of intravenous-enhanced multidetector row computed tomography (MDCT), superparamagnetic iron oxide-enhanced magnetic resonance imaging (SPIO-MRI), multidetector row computed tomography with arterioporto graphy combined with multidetector row computed tomography with hepatic arteriography (CTAP/CTHA), and intraoperative ultrasonography (IOUS) for detecting hepatic metastases front colorectal carcinoma were evaluated based on histopathologic examination of resected livers.Study: MDCT, SPIO-MRL CTAP/CTHA, and IOUS were performed routinely to determine surgical indications and methods in patients with hepatic metastases from colorectal carcinoma. The resected liver specimens were then cut serially into sections 3 to 5 mm thick for routine histologic examination.Results: Fifty metastatic lesions were detected by histopathologic study of a large amount of anatomically resected liver from 8 patients with colorectal liver metastasis. The tumors ranged in size from 3 to 53 mm (mean 13.8 mm) and 26 lesions (52%) were less than 10 mm in diameter. Histopathologic examination of the resected liver specimens showed that CTAP/CTHA was the most sensitive imaging modality, followed in order by IOUS, SPIO-MRI. and MDCT. Among all the tumors detected by CTAP/CTHA, SPIO-MRI overlooked 5, but all of the tumors detected by SPIO-MRI were also detected by CTAP/CTHA. The number of metastatic liver tumors detected differed significantly among MDCT, SPIO-MRI, and histopathologic examination. One false-positive lesion was detected by IOUS.Conclusions: CTAP/CTHA is a useful preoperative imaging modality for detecting small hepatic metastases from colorectal carcinoma.