SPECT肝脏模拟切除术后残留肝的功能价值

目的 :探讨SPECT肝脏模拟切除术后残留肝的功能价值。方法 :用SPECT肝脏断层图像测定 11例肝癌及 9例肝血管瘤的肝功能容积 ,对肝癌患者模拟肝预切除术 ,将残留肝的功能容积与全肝吲哚氰绿 15min滞留率 (ICGR1 5)结合 ,预测残留肝的储备功能。结果 :肝血管瘤患者的肝平均功能容积明显大于肝癌患者的肝平均功能容积 (P <0 0 5 )。转移性肝癌患者的肝功能容积明显大于原发性肝癌患者 (P<0 0 5 )。肝脏模拟切除术后残留肝的功能容积 >70 0mL ,预后良好 ;<4 0 0mL较差。结论 :肝脏肿瘤患者术后残留肝的功能容积与患者预后存在明显相关性 ,此研究为肝肿瘤术前评估和手术方式选择提供了依据。

Functional Evaluation of Residual Liver after Simulated Hepatectomy by SPECT

Objective:To evaluate the function of residual liv er after simulated hepatectomy by SPECT.Method:The liver functional volume(LFV)of 11 patients with liver carcinoma and 9 of liver hemangioma was determined by SPECT.Patients with liver carcinoma were performed with simulate d hepatectomy and the functional volume of residual liver was combined with whol e liver ICGR 15 to predetermine the reserved ability of the residual liver. Results:The LFV of the patients with liver hemangioma was larger than that with liver carcinoma(P<0 05).Among the data of the p atients with liver cancer,the LFV of the patients with metastatic liver carcinom a was bigger than that of patients with hepatocellular carcinoma( P<0 05).The prognosis of patients who the functional volume o f the residual liver was more than 700 mL was better than that of patients of le ss than 400mL.Conclusion:there is a closed correlation between the LFV of the pa tients with liver tumor after operation and the prognosis of ones.This provides a basic guide for doctor to choose a better strategy for patients with liver can cer.