腹腔镜对影像学检查阴性肝癌的诊断价值  

The role of laparoscopy in hepatoma patients clinically suspected with negative imaging findings

作　　者：安子元[1] 苗志[2] 郭同刚 闫柱[1] 徐大毅[1] 

机构地区：[1]山西医学院第一附属医院消化科 [2]太原市商业职工医院,030001 [3]十三冶金公司医院

出　　处：《新消化病学杂志》1995年第2期98-99,共2页

摘　　要：目的 探讨腹腔镜对影像学检查阴性肝癌的诊断价值。 方法 对42例临床怀疑肝癌而超声波检查、CT扫描和肝脏数字减影均阴性的患者做腹腔镜检查,使用A5201和国产QJF腹腔镜。 结果 病理证实原发性肝细胞癌6例,转移性肝癌1例。镜下特点为肝脏弥漫性肿大,表面有糜烂或<1cm结节或溃疡,另1例腹腔镜诊断慢性迁延性肝炎,6个月后发现肝占位病变,B超引导下穿刺活检证实肝细胞癌。 结论 现代影像学不能完全取代腹腔镜检查,二者各有优势和缺陷,必须互相补充才能提高肝癌诊断水平。对二者均阴性而临床怀疑肝癌的患者应严密随访。AIM To evaluate the role of laparoscopy in hepatoma patients clinically suspected with negative imaging findings.METHODS Fourty - two patients with clinically suspected hepatic carcinoma and negative B - ultrasound and CT scan findings underwent laparoscopy with Olympus A5201 and QJF laparoscopes. RESULTS The final diagnoses were hepatocellular carcinoma in 6 patients, liver metastatic carcinoma in one patient, chronic hepatitis in 4, liver cirrhosis in 25, metastatic carcinoma to peritoneum in 4, tuberculous peritonitis in one and no finding in one patient. The laparoscopic features of these seven hepatic cancers were diffused hepatomegaly with superficial erosion, and nodules or ulcers less than 1 cm in diameter on the surface of the liver.CONCLUSION Negative ultrasound and CT findings can not exclude liver malignancy. Laparoscopy is the procedure of choice in evaluating these patients and may have significant yields.

关 键 词：腹腔镜 肝癌 影像学检查 

分 类 号：R735.704[医药卫生—肿瘤]