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

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.