结直肠癌肝转移行肝转移灶切除术前影像学评估  

Preoperative imaging evaluation for resectable colorectal liver metastasis

作　　者：钟芸诗[1] 曾蒙苏[2] 许剑民[1] 

机构地区：[1]复旦大学附属中山医院普外科复旦大学普通外科研究所,上海200032 [2]复旦大学附属中山医院放射科上海市影像医学研究所,上海200032

出　　处：《中国实用外科杂志》2013年第8期650-653,共4页Chinese Journal of Practical Surgery

基　　金：卫生部部属(管)医院临床学科重点项目(2010-2012年度项目);国家自然科学基金(30973416,81101566);上海市卫生局人才基金(XYQ2011017,XBR2011031);上海市科委启明星计划(12QA1400600)

摘　　要：在过去20年,肝转移灶切除术逐渐成为改善转移性结肠癌病人预后的一种颇有前景的手段,在部分病例中,还提供了长期治愈的可能。为了使转移病灶切除术的安全性和疗效最大化,适宜的术前影像学检查必不可少。CT、MRI以及PET的发展不仅改善了对隐匿病灶的检出能力,同时也优化了解剖结构的定位。MRI在发现小于厘米级大小的肝转移病灶上更有优势。CT可作为一种筛检手段或在做术前计划中比较有用,例如估算残余肝脏容积或在术前为肝动脉灌注泵的安置确定动脉解剖位置。Over the past two decades, hepatic metastasectomy has emerged as a promising technique for improving survival in patients with metastatic colon cancer and in some cases providing long-term cure. Appropriate preoperative imaging could maximize the safety and efficacy of metastasectomy. Advancements in computed tomography （CT）, magnetic resonance imaging （MRI） and positron emission tomography （PET） have led to improved detection of occult lesions andbetter definition of surgical anatomy. MRI excels at detection of subcentimeter liver metastases compared to CT and FDG-PET. CT may be useful as a screening modality or in preoperative planning such as volumetric estimation of the remnant liver size or in defining preoperative arterial anatomy for hepatic artery infusion pump placement.

关 键 词：结直肠癌 肝转移 肝切除术 影像学检查 

分 类 号：R6[医药卫生—外科学]