caa a22 4500 475801407 CHVBK 20180406123738.0 cr unu---uuuuu 170329e20000101xx s 000 0 eng 10.1007/s002689910009 doi (NATIONALLICENCE)springer-10.1007/s002689910009 Intraoperative Ultrasonography versus Helical Computed Tomography and Computed Tomography with Arterioportography in Diagnosing Colorectal Liver Metastases: Lesion-by-lesion Analysis [Elektronische Daten] [Johannes Schmidt, Markus Strotzer, Stefan Fraunhofer, Herman Boedeker, Hubert Zirngibl] Helical computed tomography with arterioportography (CTAP) and intraoperative sonography (IOUS) are both recognized to be extremely sensitive in the detection of liver metastases measuring <2 cm in diameter. As sensitivity and specificity values for both techniques differ significantly in the literature and in default of sufficient published data regarding this subject, a lesion-by-lesion analysis was considered necessary. Accuracy of IOUS was compared with helical computed tomography (CT) and portal-phase contrast enhancement (CTAP) in the preoperative detection of liver metastases from colorectal carcinoma projected as a prospective blinded study. Cost efficiency should be determined. Liver CTAP and IOUS were evaluated in 33 patients with colorectal carcinoma. Metastases were resected in 10 cases, and the remaining 23 patients were observed for follow-up with CT investigations every 3 months for a period of 1 year. CTAP and IOUS detected all 13 lesions measuring 5-10 mm (13/13). One metastasis measuring >10 mm was missed by IOUS. CTAP presented an ideal sensitivity of 100%, but specificity was as low as 68%. IOUS sensitivity was 98% and specificity was 95%. IOUS and CTAP are of comparable value regarding the detection of liver metastases <10 mm. Both techniques may be used if resections of synchronous or metachronous metastases are planned in order not to miss limiting small lesions and to prevent superfluous liver surgery. Helical CT scan with dynamic intravenous contrast enhancement is considered the most cost-effective preoperative staging method, although local staging may not be achieved because of insufficient intraabdominal survey. by the Société Internationale de Chirurgie, 2000 Schmidt Johannes Department of Surgery, University of Witten-Herdecke, Heusner-Strasse 40, D-42883 Wuppertal, Germany, DE aut Strotzer Markus Department of Radiology, University of Regensburg, Franz-Josef-Strauss-Allee 11, D-93042 Regensburg, Germany, DE aut Fraunhofer Stefan Department of Surgery, University of Witten-Herdecke, Heusner-Strasse 40, D-42883 Wuppertal, Germany, DE aut Boedeker Herman Department of Surgery, University of Regensburg, Franz-Josef-Strauss-Allee 11, D-93042 Regensburg, Germany aut Zirngibl Hubert Department of Surgery, University of Witten-Herdecke, Heusner-Strasse 40, D-42883 Wuppertal, Germany, DE aut World Journal of Surgery Springer-Verlag 24/1(2000-01-01), 43-48 0364-2313 24:1<43 2000 24 268 https://doi.org/10.1007/s002689910009 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s002689910009 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Schmidt Johannes Department of Surgery, University of Witten-Herdecke, Heusner-Strasse 40, D-42883 Wuppertal, Germany, DE aut NATIONALLICENCE 700 1- Strotzer Markus Department of Radiology, University of Regensburg, Franz-Josef-Strauss-Allee 11, D-93042 Regensburg, Germany, DE aut NATIONALLICENCE 700 1- Fraunhofer Stefan Department of Surgery, University of Witten-Herdecke, Heusner-Strasse 40, D-42883 Wuppertal, Germany, DE aut NATIONALLICENCE 700 1- Boedeker Herman Department of Surgery, University of Regensburg, Franz-Josef-Strauss-Allee 11, D-93042 Regensburg, Germany aut NATIONALLICENCE 700 1- Zirngibl Hubert Department of Surgery, University of Witten-Herdecke, Heusner-Strasse 40, D-42883 Wuppertal, Germany, DE aut NATIONALLICENCE 773 0- World Journal of Surgery Springer-Verlag 24/1(2000-01-01), 43-48 0364-2313 24:1<43 2000 24 268 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer