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首页> 外文期刊>Journal of Clinical Ultrasound: JCU >Impact of intraoperative sonography on resection and cryoablation of liver tumors.
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Impact of intraoperative sonography on resection and cryoablation of liver tumors.

机译：术中超声检查对肝肿瘤切除和冷冻消融的影响。

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PURPOSE: We retrospectively analyzed the impact of intraoperative sonography (IOUS) on the management of patients referred for resection of liver tumors. METHODS: Forty patients underwent IOUS with a 7-MHz curved-array sector transducer; in selected cases, a 5-MHz linear-array transducer attached to a color Doppler unit was also used. The number, size, and location of tumors on IOUS, including tumor proximity to or invasion of major vessels or invasion of the diaphragm, were compared to findings on preoperative imaging studies. The effect of these findings on surgical management was assessed. Unresectable lesions were treated by cryoablation under ultrasound guidance. RESULTS: IOUS detected preoperatively unsuspected lesions in 7 patients (18%). Metastases suspected on CT arterial portography were ruled out in 2 patients (5%), and indeterminate lesions were diagnosed as cysts by IOUS in 2 other patients (5%). Vascular proximity or vascular or diaphragmatic invasion detected by IOUS rendered lesions unresectable in 4 patients (10%). Cryoablation under IOUS guidance and monitoring was attempted in 11 patients (28%) and performed successfully in 10. CONCLUSIONS: IOUS changed the management in 38% of patients and guided cryoablation in 28% of patients. IOUS performed by an experienced sonologist is invaluable for the accurate assessment of liver tumor resectability; the detection of additional, preoperatively unknown lesions; and the guidance of cryoablation of unresectable tumors. Copyright 2001 John Wiley & Sons, Inc.
机译：目的：我们回顾性分析术中超声检查（IOUS）对肝癌切除术患者管理的影响。方法：40例患者接受了7MHz弯曲阵列扇形换能器的IOUS治疗。在某些情况下，还使用了与彩色多普勒仪相连的5MHz线性阵列换能器。将IOUS上的肿瘤的数量，大小和位置（包括肿瘤靠近或侵入主要血管或横diaphragm膜）与术前影像学检查结果进行比较。评估了这些发现对手术管理的影响。不可切除的病变在超声引导下通过冷冻消融术治疗。结果：IOUS在7例患者中发现了术前未怀疑的病变（18％）。 2例（5％）排除了在CT动脉门静脉造影上怀疑的转移灶，另外2例（5％）的IOUS将不确定的病变诊断为囊肿。通过IOUS检测到的血管近距或血管或diaphragm肌浸润使4例患者无法切除（10％）。在IOUS的指导和监测下尝试冷冻消融的11例患者（占28％），在10例中成功进行了结论。由经验丰富的超声医师进行的IOUS对于准确评估肝肿瘤的可切除性具有不可估量的价值。检测其他术前未知的病变;和冷冻切除不可切除肿瘤的指导。版权所有2001 John Wiley＆Sons，Inc.

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