Intraoperative US in patients undergoing surgery for liver neoplasms: Comparison with MR imaging
Intraoperative US in patients undergoing surgery for liver neoplasms: Comparison with MR imaging
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DOI：
10.1148/radiol.2323030896
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发表时间：
2004-09-01
期刊：
影响因子：
19.7
通讯作者：
Mueller, PR
中科院分区：
文献类型：
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作者：
Sahani, DV;Kalva, SP;Mueller, PR
目的：回顾性比较术中超声检查 (US) 和术前使用造影剂增强的磁共振 (MR) 成像对肝切除患者肝脏病变的描绘。 材料和方法：放射科医生 (D.V.S.) 和外科医生 (K.K.T.) 回顾性识别了 79 名患者（36 名女性和 43 名男性患者；年龄范围，10-78 岁；平均年龄，57 岁）年）因原发性肝脏肿瘤或转移灶接受过手术切除，并且在术前 6 周内接受过术前增强磁共振成像。使用 1.5-T 系统进行 MR 成像。在外科医生充分动员肝脏后，胃肠道放射科医生使用 7.5 MHz 线性阵列传感器进行或监督肝脏的专用术中超声检查。以159个切除的肝病灶的组织病理学评估作为参考标准。病灶分布包括结肠癌转移（n = 122）、肝细胞癌（n = 23）、胆管癌（n = 6）、海绵状血管瘤（n = 4）、局灶性结节性增生（n = 2）、错构瘤（n = 1）和转移性胚胎肉瘤（n = 1）。 结果：159个病灶中，138个(86.7%) 在 MR 成像和术中超声中均被识别。仅在术中超声检查时才在 10 名患者中检测到 12 个额外病变 (7.5%)（8 个转移瘤、1 个肝细胞癌、1 个胆管癌、1 个血管瘤和 1 个胆道错构瘤）。两种方法均未能描绘 9 个病变 (5.6%)（4 个转移瘤、4 个肝细胞癌和 1 个胆管癌）。磁共振成像和术中超声对肝脏病灶描绘的敏感性分别为86.7%和94.3%。分别。 10 名患者中只有 3 名 (4%) 根据术中超声结果改变了手术治疗。结论：在肝切除前描绘肝脏病变方面，对比增强 MR 成像与术中超声一样敏感。 (C) 北美放射学会 2004 年。
PURPOSE: To retrospectively compare intraoperative ultrasonography (US) and preoperative magnetic resonance (MR) imaging with contrast material enhancement for the depiction of liver lesions in patients undergoing hepatic resection.MATERIALS AND METHODS: A radiologist (D.V.S.) and a surgeon (K.K.T.) retrospectively identified 79 patients (36 female and 43 male patients; age range, 10-78 years; mean age, 57 years) who had undergone surgical resection for primary liver tumor or metastasis and had also undergone preoperative contrast-enhanced MR imaging within 6 weeks before surgery. MR imaging was performed with a 1.5-T system. Dedicated intraoperative US of the liver was performed or supervised by a gastrointestinal radiologist using a 7.5-MHz linear-array transducer, after adequate hepatic mobilization by the surgeon. Histopathologic evaluation of the 159 resected hepatic lesions served as the reference standard. The lesion distribution included colon cancer metastasis (n = 122), hepatocellular carcinoma (n = 23), cholangiocarcinoma (n = 6), cavernous hemangioma (n = 4), focal nodular hyperplasia (n 2), hamartoma (n = 1), and metastatic embryonal sarcoma (n = 1).RESULTS: Of 159 lesions, 138 (86.7%) were identified at both MR imaging and intraoperative US. Twelve additional lesions (7.5%) in 10 patients were detected only at intraoperative US (eight metastases, one hepatocellular carcinoma, one cholangiocarcinoma, one hemangioma, and one biliary hamartoma). Both modalities failed to depict nine lesions (5.6%) (four metastases, four hepatocellular carcinomas, and one cholangiocarcinoma). The sensitivities of MR imaging and intraoperative US for liver lesion depiction were 86.7% and 94.3%. respectively. Surgical management was altered on the basis of the intraoperative US findings in only three of 10 patients (4%).CONCLUSION: Contrast-enhanced MR imaging is as sensitive as intraoperative US in depicting liver lesions before hepatic resection. (C) RSNA 2004.