title: Contrast-enhanced intraoperative ultrasonography using perfluorobutane microbubbles for the enumeration of colorectal liver metastases.
abstract: BACKGROUND
  Intraoperative ultrasonography (IOUS) is considered the standard for the identification of liver metastases. Use of lipid-stabilized perfluorobutane microbubbles as an ultrasound contrast agent may improve this. The value of contrast-enhanced IOUS (CE-IOUS) in enumerating colorectal liver metastases was studied here.
  
  
  METHODS
  CE-IOUS was performed in consecutive resections for colorectal liver metastases in 2007-2010. All patients underwent preoperative computed tomography. Magnetic resonance imaging was not carried out routinely. Conventional intraoperative examination including IOUS, and CE-IOUS with peripherally injected contrast were performed. The histopathological findings and 6-month follow-up images were used as the reference standard.
  
  
  RESULTS
  The study group of 102 patients had a total of 315 lesions identified on preoperative imaging (2·4 lesions per operation; 129 operations). Conventional intraoperative examination including IOUS identified 350 lesions (2·7 per operation). CE-IOUS identified 370 lesions (2·9 per operation). The sensitivity, specificity and accuracy of CE-IOUS were 97·1, 59·1 and 93·2 per cent respectively. The CE-IOUS findings altered the surgical plan in 19 operations (14·7 per cent).
  
  
  CONCLUSIONS
  CE-IOUS provided additional information to that obtained using contemporary preoperative imaging and conventional intraoperative examinations.
authors: Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
authors: M
authors: M
authors: Takahashi
authors: K
authors: K
authors: Hasegawa
authors: J
authors: J
authors: Arita
authors: S
authors: S
authors: Hata
authors: T
authors: T
authors: Aoki
authors: Y
authors: Y
authors: Sakamoto
authors: Y
authors: Y
authors: Sugawara
authors: N
authors: N
authors: Kokudo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms; D003287:Contrast Media; D005260:Female; D005466:Fluorocarbons; D006801:Humans; D007430:Intraoperative Care / Q000379:methods; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary* / Q000601:surgery; D008297:Male; D045423:Microbubbles; D008875:Middle Aged; D012680:Sensitivity and Specificity; D014463:Ultrasonography
chemical_list: D003287:Contrast Media; D005466:Fluorocarbons; C108042:perfluorobutane