DETECTION OF MALIGNANT-TUMORS IN END-STAGE CIRRHOTIC LIVERS - EFFICACY OF SONOGRAPHY AS A SCREENING TECHNIQUE

被引:119
作者
DODD, GD
MILLER, WJ
BARON, RL
SKOLNICK, ML
CAMPBELL, WL
机构
关键词
D O I
10.2214/ajr.159.4.1326883
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
OBJECTIVE. Patients with hepatic cirrhosis are at an increased risk of developing primary malignant tumors of the liver. If these tumors are discovered early, current therapies may be curative. We conducted a prospective study to assess the accuracy of sonographic screening for the detection of malignant tumors in cirrhotic livers as determined by correlation with resected whole livers. SUBJECTS AND METHODS. A total of 200 prospectively interpreted preoperative sonograms from 200 patients with cirrhosis who underwent hepatic transplantation were correlated with specimens of freshly resected whole livers. The results were analyzed to determine the sensitivity and specificity of sonography in identifying patients with malignant tumors and detecting individual tumors in each patient. RESULTS. Pathologic examination showed 80 malignant lesions in 34 patients (28 with hepatocellular carcinoma, three with cholangiocarcinoma, two with metastases, and one with non-Hodgkin's lymphoma) and three hemangiomas in two patients. Sonography correctly showed malignant tumors in 17 of the 34 patients, for a sensitivity of 50%. Sonograms were false-positive for malignant tumors in three patients, two of whom had a total of three hemangiomas. Sonography correctly showed 36 of the 80 malignant lesions, for a lesion sensitivity of 45% and specificity of 98%. Of the 44 missed lesions, 24 were 1 cm or less, 12 were between 1 and 3 cm, and eight were more than 3 cm in diameter. CONCLUSION. Our results show that sonography is highly insensitive in the detection of malignant lesions in end-stage cirrhotic livers and thus is not a reliable screening technique. However, because of sonography's very high specificity, any sonographically identified lesion in a cirrhotic liver should be considered malignant until proved otherwise.
引用
收藏
页码:727 / 733
页数:7
相关论文
共 22 条
  • [1] CHEN DS, 1977, CANCER, V40, P779, DOI 10.1002/1097-0142(197708)40:2<779::AID-CNCR2820400227>3.0.CO
  • [2] 2-Y
  • [3] ULTRASOUND IN THE DIAGNOSIS OF HEPATOCELLULAR-CARCINOMA ASSOCIATED WITH CIRRHOSIS
    COTTONE, M
    MARCENO, MP
    MARINGHINI, A
    RINALDI, F
    RUSSO, G
    SCIARRINO, E
    TURRI, M
    PAGLIARO, L
    [J]. RADIOLOGY, 1983, 147 (02) : 517 - 519
  • [4] RESECTION OF HEPATOCELLULAR CARCINOMAS - RESULTS IN 72 EUROPEAN PATIENTS WITH CIRRHOSIS
    FRANCO, D
    CAPUSSOTTI, L
    SMADJA, C
    BOUZARI, H
    MEAKINS, J
    KEMENY, F
    GRANGE, D
    DELLEPIANE, M
    [J]. GASTROENTEROLOGY, 1990, 98 (03) : 733 - 738
  • [5] HEPATIC PERFUSION ABNORMALITIES DURING CT ANGIOGRAPHY - DETECTION AND INTERPRETATION
    FREENY, PC
    MARKS, WM
    [J]. RADIOLOGY, 1986, 159 (03) : 685 - 691
  • [6] FUJIYAMA S, 1988, CANCER, V61, P1621, DOI 10.1002/1097-0142(19880415)61:8<1621::AID-CNCR2820610820>3.0.CO
  • [7] 2-C
  • [8] METASTATIC NODULES OF HEPATOCELLULAR-CARCINOMA - DETECTION WITH ANGIOGRAPHY, CT, AND US
    HAYASHI, N
    YAMAMOTO, K
    TAMAKI, N
    SHIBATA, T
    ITOH, K
    FUJISAWA, I
    NAKANO, Y
    YAMAOKA, Y
    KOBAYASHI, N
    MORI, K
    OZAWA, K
    TORIZUKA, K
    [J]. RADIOLOGY, 1987, 165 (01) : 61 - 63
  • [9] DETECTION OF FOCAL HEPATIC MASSES - PROSPECTIVE EVALUATION WITH CT, DELAYED CT, CT DURING ARTERIAL PORTOGRAPHY, AND MR IMAGING
    HEIKEN, JP
    WEYMAN, PJ
    LEE, JKT
    BALFE, DM
    PICUS, D
    BRUNT, EM
    FLYE, MW
    [J]. RADIOLOGY, 1989, 171 (01) : 47 - 51
  • [10] INTRAOPERATIVE SONOGRAPHY - CLINICAL USEFULNESS IN LIVER SURGERY
    IGAWA, S
    SAKAI, K
    KINOSHITA, H
    HIROHASHI, K
    [J]. RADIOLOGY, 1985, 156 (02) : 473 - 478