超声造影在原发性肝癌切除术中的应用(附42例报告)

葛明刚; 张伟; 朱宇

doi:10.3969/j.issn.1001-5256.2014.03.011

超声造影在原发性肝癌切除术中的应用(附42例报告)

DOI: 10.3969/j.issn.1001-5256.2014.03.011

遂宁市中心医院肝胆外科

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中图分类号: R735.7
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出版历程
- 收稿日期: 2013-07-11
- 出版日期: 2014-03-20

Application of contrast-enhanced ultrasound in hepatectomy for primary liver cancer: a report of 42 cases

Department of Hepatobiliary Surgery, Suining Central Hospital

摘要

摘要:
目的探讨超声造影在原发性肝癌切除术中的价值。方法收集本院肝胆外科2010年1月至2011年12月收治的术中采用超声造影指导行肝切除术的病例资料,共计42例,将其在肝癌切除术中超声造影检查发现的病灶数目、大小、与肝内管道的关系等与术前超声、CT、术中超声发现的病灶的数目、大小、与肝内管道的关系等进行比较。结果术中超声造影检查除发现术前超声、CT等影像学检查发现的阳性病灶外,术中超声造影还能更准确的判断肝内病灶的数目、性质和病灶与肝内管道的关系等,更清楚显示了主病灶的卫星结节8例;新发现门脉癌栓共6例,其中主干2例,门脉左支1例,门脉右支3例。发现胆总管癌栓2例、下腔静脉癌栓1例;发现3例远离原病灶的小病灶(约0.5 cm)。结论在原发性肝癌切除术中超声造影能发现残留病灶,避开重要的解剖结构,有重要的应用价值。
- 肝肿瘤 /
- 超声检查 /
- 造影剂 /
- 肝切除术
Abstract:
Objective To investigate the value of contrast- enhanced ultrasound ( CEUS) in the hepatectomy for primary liver cancer. Methods The clinical data of 42 patients who underwent CEUS- guided hepatectomy for primary liver cancer in the department of hepatobiliary surgery of our hospital from January 2010 to December 2011 were collected. The number of lesions, lesion sizes, and relationship between lesions and intrahepatic bile ducts as determined by CEUS during hepatectomy were compared with those determined by preoperative ultrasound and computed tomography ( CT) . Results In addition to the positive lesions found by preoperative ultrasound and CT, the intraoperative CEUS could more accurately determine the number and nature of intrahepatic lesions and relationship between lesions and intrahepatic bile ducts and more clearly show the satellite nodules of primary lesion ( in 8 cases) . Portal vein tumor thrombus ( PVTT) was newly found in 6 cases; of these cases, 2 had PVTT in the main trunk of the portal vein, 1 had PVTT in the left branch of the portal vein, and 3 had PVTT in the right branch of the portal vein. Common bile duct tumor thrombus was found in 2 cases, and inferior vena cava tumor thrombus in 1 case. Small lesions ( around 0. 5 cm) distant from the primary lesion were found in 3 cases. Conclusion In the hepatectomy for primary liver cancer, CEUS can find residual lesions and avoid important anatomical structures, which is of great application value.
- liver neoplasms /
- ultrasonography /
- contrast media /
- hepatectomy

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参考文献(14)

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