CT测量肝脏体积指数对胆管闭锁肝硬化程度的评价

目的 探讨CT测量肝脏体积指数（LVI）在胆管闭锁肝硬化评估中的价值。方法 将2006年1月—2013年2月我院住院的胆管闭锁病儿41例作为研究对象，肝纤维化程度采用Matavir分级，F0-F3为非肝硬化组，F4为肝硬化组，用64排螺旋CT测量肝脏体积（LV），根据公式计算LVI，并绘制LVI的ROC曲线。结果肝硬化组病儿LVI低于非肝硬化组，差异有显著性（t=－3.72,P〈0.01）；LVI的ROC曲线下面积为0.88，选择0.84作为诊断界点时，其诊断的灵敏度为91%，特异度为83%。结论 LVI可准确地反应胆管闭锁病儿LV变化的程度，对于评价胆管闭锁病儿的肝硬化程度有较高准确性和可靠性，可用于预测预后和提早做好肝移植准备。

THE VALUE OF CT-MEASURED LIVER VOLUME INDEX FOR PREDICTION OF LIVER CIRRHOSIS IN PATIENTS WITH BILIARY ATRESIA

Objective To explore the value of CT-measured liver volume index （LVI） in evaluating cirrhosis due to biliary atresia. Methods This study consisted of 41 cases of biliary atresia patients hospitalized between January 2006 and February 2013. The degree of hepatic fibrosis was graded using Metavir classification as follows： F0-F3 grade was considered non-cirrhosis, F4 grade as hepatic cirrhosis. LV was measured using 64-row spiral CT in all research objects, and LVI was calculated according to the formula, and receiver operating characteristic （ROC） curves of LVI plotted. Results The LVI of the sick kids was lower than those in the non-cirrhosis group, the difference was significant （t=-3.72,P〈0.05）. The area of LVI under ROC curve was 0.88, when selecting 0.84 as the diagnostic cut-off point, its diagnostic sensitivity was 91%, and the specificity was 83%. Conclusion LVI can accurately reflect the changes of LV in kids with biliary atresia, which is of higher accuracy and reliability in assessment of hepatic cirrhosis in kids with biliary atresia, and can be used to predict prognosis and prepare a liver transplantation at an earlier time.