Contrast-enhanced intraoperative ultrasonography equipped with late Kupffer-phase image obtained by sonazoid in patients with colorectal liver metastases.
OBJECTIVE
To find occult metastases during hepatectomy in patients with colorectal cancer liver metastases (CRCLM), contrast-enhanced intraoperative ultrasonography (CE-IOUS) was performed using a new microbubble agent, sonazoid, which provides a parenchyma-specific contrast image based on its accumulation in the Kupffer cells.


METHODS
Eight patients with CRCLM underwent CE-IOUS using sonazoid before hepatectomy. The liver was investigated during a late Kupffer-phase imaging, which is a valuable characteristic of sonazoid.


RESULTS
CE-IOUS using sonazoid provided the early vascular- and sinusoidal-phase images for 10 min followed by the late Kupffer-phase image up to 30 min after the injection of sonazoid. IOUS did not provide new findings of metastatic lesion in the 8 patients. However, during the late Kupffer-phase image of sonazoid, a metastatic lesion was newly found in two of the 8 patients. These newly detected lesions were removed by an additional hepatectomy and histopathologically diagnosed as a metastasis.


CONCLUSIONS
CE-IOUS using sonazoid can allow surgeons to investigate the whole liver with enough time and to find new metastases intraoperatively.
Department of Surgery, Yokohama Asahi-Chuo General Hospital, 4-20-1 Wakabadai, Asahi-ku, Yokohama 241-0801, Japan. nakahiro@marianna-u.ac.jp
Hiroshi
H
Nakano
Yasuo
Y
Ishida
Toshiyuki
T
Hatakeyama
Kazuma
K
Sakuraba
Masahiro
M
Hayashi
Osamu
O
Sakurai
Kiyoshi
K
Hataya
D015179:Colorectal Neoplasms / Q000473:pathology*; D003287:Contrast Media; D005290:Ferric Compounds; D006498:Hepatectomy; D006801:Humans; D007501:Iron; D007728:Kupffer Cells / Q000473:pathology*; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary* / Q000601:surgery; D008279:Magnetic Resonance Imaging; D045423:Microbubbles; D010087:Oxides; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D018084:Ultrasonography, Interventional
D003287:Contrast Media; D005290:Ferric Compounds; D010087:Oxides; C069727:Sonazoid; D007501:Iron