肝炎后肝硬化患者肝容积、CT值、肝脾容积比与肝功能的关系

目的 探讨肝容积指数、容积变化率、肝脾容积比指标与肝功能Child分级间的对应关系.方法 选择肝炎后肝硬化组38例和正常成人组40例,对两组个体行腹部多层螺旋CT增强扫描,采用选择性VR自动测量法测量肝容积,计算肝容积指数、肝容积变化率及肝脾容积比,并分析肝容积指数、容积变化率、肝脾容积比指标与Child分级间的对应关系.结果 正常组肝脏容积与身高、体重、体表面积间的相关系数r分别为0.740、0.815、0.852.肝功能Child B级和C级患者的CT测量肝容积均明显小于正常成人,肝功能Child C级患者的CT测量肝容积均明显小于Child B级患者;Child B级和C级患者的肝容积指数均较A级患者降低,而肝容积变化率则均较A级患者增高;Child C级患者的肝容积指数较B级患者降低,而肝容积变化率则较B级患者增高;肝硬化各组的平均CT测量值和肝脾容积比均低于正常组,而平均CT值标准差则均高于正常组;Child C级患者的平均CT值标准差均较A级和B级患者增高（均P〈0.01）;Child B级和C级患者的肝脾容积比均较A级患者降低（均P〈0.05）.结论 肝炎后肝硬化患者肝容积指数、容积变化率等指标与肝功能Child分级间具有良好的对应关系;肝脏平均CT值及其标准差、肝脾容积比可在一定程度上反映患者的病肝功能状态.

The correlation of liver volume variation, CT value and liver-spleen volume ratio with liver function in patients with posthepatitic cirrhosis

Objective To investigate the correlation of liver volume variation, CT value and liver-spleen volume ratio with fiver function in patients with posthepatitic cirrhosis. Methods Thirty eight patients with posthepatitic cirrhosis and 40 normal subjects underwent multidetector computed tomography （MDCT） scan. The standard liver volume equation was deduced. The variation of liver volume, CT value and liver-spleen volume ratio of cirrhosis patients were calculated and compared with Child-pugh classification. Results In cirrhosis patients,the child classifications were negatively correlated with the liver volume and liver volume index （P〈O.05）, while were positively correlated with the change ratio of liver volume. There were no significant difference of CT value among Child A, B and C groups （P〉0.05）, while the CT value standard deviation of Child C group was significantly lager than that of Child A and B groups （P〈0.01）. The liver-spleen volume ratio of Child A group was significantly higher than that of Child B and C groups. Conclusion Liver volume variation of cirrhotic patients can be quantitatively assessed by MDCT volume measurement. The volume index and volume change ratio are well correlated with the Child-pugh classification of liver function in patients with posthepatitic cirrhosis.