1,721,190 research outputs found
Adverse effects associated with SonoVue(registered trademark) use
No full textConventional ultrasonography (US) has limited accuracy in the detection and characterisation of solid focal liver lesions (FLL). Contrast-enhanced ultrasound (CEUS) significantly improves the diagnostic performance of US in the assessment of FLL. Rare reports of serious adverse events have been reported with CEUS. The rates of adverse reactions reported from the use of ultrasound contrast agents seem comparable to, or lower than, those observed for other imaging modalities that use contrast agents such as computed tomography and magnetic resonance imaging. Improved diagnostic results and diagnostic confidence achieved in conventional CEUS studies of the liver and during the investigational use in the intraoperative CEUS exploration appear to justify the use of this promising modality. (copyright) 2005 Ashley Publications Ltd
Surgical technique: new advancements for expanding indications and safety: the Western experience
No full textThe technical issues discussed herein represent part of the panorama of innovative approaches proposed for the surgical treatment of hepatocellular carcinoma (HCC); in particular, the attention is focused on the recent advances in the field of planning the surgical strategy and performing liver dissection via ultrasound guidance. It is described how recent technical advances have allowed the range of scenarios for which surgery is indicated in liver cirrhosis patients with HCC to be widened. Indeed, the ability to spare the liver parenchyma with respect to liver inflow and outflow and its biliary drainage as well as to perform the anatomic removal of subsegmental portions of the liver has enabled surgeons to provide new therapeutic horizons, and will probably result in modifications to the therapeutic flow charts of HCC patients once the new horizons are fully accepted by nonsurgical specialists devoted to the treatment of these complex patients
Intraoperative ultrasound in surgery for hepatocellular carcinoma
No full textImaging-guided therapeutic procedures have modified the approach to HCC both introducing new treatment modalities and also changing the policy of hepatectomies. Indeed, with intraoperative ultrasonography (IOUS) it is possible to achieve better knowledge about tumor location and staging, also with the aid of contrast-enhanced IOUS. However, IOUS also allows to minimise the rate of major hepatectomies maintaining treatment radicality and widening the indication at surgery. Indeed, precise definition of tumor-vessel relationship, intrahepatic vessel distribution and color-Doppler analysis allows performing hepatectomies otherwise not possible. This so-called "radical but conservative" policy has allowed us a safe surgical approach with minimal mortality and major morbidity and effective local treatment with no tumor relapses at the site of the resection. Techniques for safe and radical IOUS-guided liver resections for HCC are here discussed
Letter 2: Contrast-enhanced ultrasonography during liver surgery (Br J Surg 2004; 91 : 1165-1167)
No full textContrast-enhanced intraoperative ultrasonography in surgery for liver tumors
No full textIOUS is the most accurate diagnostic technique for assessing focal liver lesions, but still has some drawbacks. Contrast-enhanced ultrasound examination done intraoperatively (CE-IOUS), using second generation contrast agents (SonoVue, Bracco-Imaging, Milan, Italy), seems able to overcome those aforementioned lacking aspects of IOUS. In cirrhotic patients with hepatocellular carcinoma (HCC), CE-IOUS provides information about tumor vascularity which are useful for nodules differentiation: this should improve the surgical radicality. Furthermore, two different pattern of enhancement are also recognizable at CE-IOUS in those HCC nodules depicted preoperatively: one of them has no similarity with that observed at computed tomography (CT). In patients who undergo surgery for colorectal liver metastases, CE-IOUS seems to improve the sensitivity of IOUS to small, hypoechoic lesions, reducing the risk to down-stage the disease and enhancing the rate of treatment with curative intent. In conclusion, IOUS accuracy is improved by CE-IOUS with an impact on surgical strategy either for primary than for metastatic tumors. Furthermore, a wider experience with vascular enhancement patterns at CE-IOUS could provide new classification for liver lesions
The Japanese approach to surgical treatment of hepatocellular carcinoma in liver cirrhosis: impressions of an Italian FPCR fellow
No full text17th World Congress of the International Association of Surgeons, Gastroenterologists and Oncologists
No full textECOGRAFIA INTRAOPERATORIA CON MEZZO DI CONTRASTO NELLA IDENTIFICAZIONE DELLE METASTASI EPATICHE
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