摘要
目的以手术病理组织学结果为金标准，探讨结直肠癌肝转移患者术前超声造影检查的临床应用价值。方法对42例结直肠癌肝转移患者行肝超声造影检查，造影所见肝内病灶数目、位置、大小与手术病理结果进行对照。结果42例切除并经病理组织学证实的肝转移癌灶96个，大小0．3～8．5cm，平均（2．6±1．8）cm，每例1～8个病灶；其中21个（21．9％）≤1．0cm。术前超声造影准确检出86个癌灶，敏感性89．6％（86／96个），对≤1．0cm癌灶敏感性71．4％（15／21个）；造影门脉期至延迟期检出的35个癌灶中19个（54．3％）常规超声未能发现。42例中治愈性手术切除率88．1％（37例），此37例术后随访3～39个月，2年内肝内复发率32．4％（12例），1年生存率90．0％。结论超声造影对结直肠癌肝转移尤其对小癌灶有较高敏感性，有助于术前准确分期，选择合理治疗方案。超声造影可作为术前无创性影像检查的重要手段之一。
Objective To evaluate the role of contrast-enhanced ultrasound （CEUS） for preoperative detection of colorectal liver metastases. Methods 42 consecutive patients with colorectal liver metastases confirmed by histopathology after surgery were recruited in the study. They all had undergone preoperative CEUS examination with contrast agent SonoVue. The number,location and size of the hepatic lesions found by CEUS were correlated with postoperatively histopathologie results on a lesion-by-lesion basis. Results 96 liver metastases in 42 patients with colorectal cancer had been resected and confirmed by histophathology. The size of the metastatic lesions ranged from 0.3-8.5 cm [average （2.6 ± 1.8）cm]. From one to eight metastatic lesions were detected in one patient. 21 （21.9 %） metastatic lesions were equal to or less than 1.0 cm. 86 of 96 metastatic lesions were correctly depicted by CEUS, with a sensitivity of 89.6%. And the sensitivity for metastatic lesions equal to or less than 1.0 cm was 71.4~ （15 of 21 tumors） by CEUS. 35 metastatic lesions were found between the portal venous phase and late phase by CEUS and 19 （54.3~） metastatic lesions among them could not be detected at conventional ultrasound. The curative resection was performed in 37 （88.1%） of 42 patients. With 3 - 39 months follow-up, the intrahepatic recurrence rate within two years was 32.4% （12 of 37 patients） and the one-year survival rate was 90.0%. Conclusions CEUS is highly sensitive for detecting liver metastases resulted from eolorectal cancer,especially for small metastatic lesions. CEUS is helpful to choose reasonable therapeutic strategies and can be regarded as one of the most importantly and noninvasively preoperative imaging modalities.
出处
《中华超声影像学杂志》
CSCD
北大核心
2012年第8期683-686,共4页
Chinese Journal of Ultrasonography
基金
北京市科委首都市民健康项目培育基金（Z111107067311026）
北京市科委重大项目培育专项基金（Z0005190040431）
北京市卫生局青年科学研究资助项目（QN2008-036）
关键词
超声检查
微气泡
结直肠肿瘤
肝肿瘤
肿瘤转移
metastases Ultrasonography
Microbubbles
Colorectal neoplasms
Liver neoplasms
Neoplasm
