First Russian experience of using Contrast-Enhanced Intraoperative Ultrasonography (CE-IOUS) in the treatment of liver lesions
For today it is difficult to imagine medical practice without modern visualization methods of instrumental diagnostics. At the same time, according to the estimates of the World Health Organization, two-thirds of the world population is deprived of such opportunities. Ultrasound diagnostics with intravenous contrasting (CEUS), which requires minimal financial costs and technical equipment, has a great potential to remedy this situation. At present, there is a growing interest in the use of echography with contrast enhancement in order to improve the efficiency of detecting focal pathology and the accuracy of differential diagnosis, incl. in surgical hepatology. Difficulties in planning the surgical tactics in patients with metastatic colorectal liver cancer are well known (discrepancy in the data of preoperative methods of radiation diagnosis about the number and segmental location of foci in the liver, the probability of additional foci). The "gold standard" of the diagnostic evaluation, which combines palpation of the liver and the performance of intraoperative ultrasound (IOUS), is now supplemented by the possibility of contrast enhancement during intraoperative echography. In this article, we present a description of the method of ultrasound diagnostics with intravenous (IV) contrasting, illustrating the possibilities of investigation by clinical cases of intraoperative ultrasound diagnostics with contrast enhancement in patients with metastatic liver cancer. Our impressions about the possibilities of ultrasound with intravenous contrast in the intraoperative diagnosis of tumor foci in patients with metastatic liver cancer we build on this little experience.