Theme |
Abdominal Ultrasonography up-to-date |
Title |
Ultrasound Guided Hepatic Tumor Biopsy and Treatment |
Author |
Kazushi Numata |
Gastroenterological Center, Yokohama City University Medical Center |
Author |
Hiroyuki Fukuda |
Gastroenterological Center, Yokohama City University Medical Center |
Author |
Manabu Morimoto |
Gastroenterological Center, Yokohama City University Medical Center |
Author |
Masaaki Kondo |
Gastroenterological Center, Yokohama City University Medical Center |
Author |
Akito Nozaki |
Gastroenterological Center, Yokohama City University Medical Center |
Author |
Katsuaki Tanaka |
Gastroenterological Center, Yokohama City University Medical Center |
[ Summary ] |
Fusion imaging can fuse US images with multiplanar reconstructed computed tomography (CT) or magnetic resonance (MR) images on a single screen in real time using a LOGIQ E9(GE Healthcare, Milwaukee, WI). To provide histological diagnosis of hepatic lesions which do not exhibit arterial hypervascularization or venous washout on contrast-enhanced CT or contrast-enhanced US but are detected in the hepatobiliary phase of contrast-enhanced MR with gadolinium-ethoxybenzyl-diethylenetriamine-pentaacetic acid (Gd-EOB-DTPA), the lesions must be detectable using US imaging. Imaging such as conventional US or contrast-enhanced US may be employed, so that a biopsy may be performed. We used fusion imaging combining, which fuses B-mode images with the hepatobiliary phase of contrast-enhanced MR images Gd-EOBDTPA as a reference image, for the detection of hepatic lesions. We also performed ablation therapy for hypervascular hepatocellular carcinoma lesions which exhibited arterial hypervascularization and venous washout on contrast-enhanced T or contrast-enhanced US. Those lesions were not detected by using B-mode guided fusion imaging combining arterial phase contrast-enhanced CT or MRI with early or late phase contrast-enhanced US. |