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目的探讨术中超声在肝脏肿瘤手术中的应用价值及其优势。方法对65例肝脏肿瘤患者行术前经腹超声(TAS)、CT和术中超声(IOUS)对比分析,以评价IOUS和术前影像学检查的差异,并评价术中超声在手术过程中的价值。结果 65例肝脏肿瘤患者共有93个肿瘤病灶,IOUS、TAS和CT的敏感度分别为97.85%、86.02%和91.40%,尤其是微小病灶IOUS明显优于TAS和CT(P<0.05);特异度分别为95.70%、81.72%和93.55%,IOUS明显优于TAS(P<0.05);IOUS发现新病灶6个,并精准定位12个术中无法触及的小病灶和辅助13例脉管内癌栓取出。结论 IOUS相比于TAS和CT具有更高的敏感度及其特异度优于TAS,并且对术者具有良好的指导作用。
Objective To explore the value and advantage of intraoperative ultrasound in hepatic tumor surgery. Methods Sixty-five patients with liver cancer underwent preoperative ultrasonography (TAS), computed tomography (CT) and intraoperative ultrasound (IOUS) comparative analysis to evaluate the differences between preoperative IOUS and preoperative imaging examination and evaluate intraoperative ultrasound in the course of surgery value. Results There were 93 tumor lesions in 65 patients with liver tumors. The sensitivity of IOUS, TAS and CT were 97.85%, 86.02% and 91.40% respectively. Especially, the micro-lesion IOUS was significantly better than TAS and CT (P <0.05) (95.70%, 81.72% and 93.55%, respectively). The IOUS was significantly better than TAS (P <0.05). Six new lesions were found in IOUS, and 12 inoperable small lesions . Conclusion IOUS has higher sensitivity and specificity than TAS and CT, and has a good guiding effect on the surgeon.