MSCT三维体积测量法对肝移植供体肝体积术前测量的研究

目的 研究应用多层螺旋CT(MSCT)对肝移植供体肝体积术前的测量,探讨供体真实肝移植体积值与MSCT测量值间的相关性.方法 对100列活体肝移植供体采用GE Light Speed 16层螺旋CT进行肝脏四期增强扫描,在ADW4.2工作站上进行后处理,采用三维重建发法测量肝静脉期图像的供体待移植肝体积.手术中对切下供体移植肝脏采用排水法测量体积.利用统计学方法,分析MSCT测量的供体待移植肝体积和排水法测量的肝体积数据,计算回归方程,得出两者之间的关系公式.结果 术前CT测量的供体待移植肝脏体积为863.86±180.989 ml,排水法测量的移植肝体积为651.67±141.222 ml,两者呈显著正相关性,(r值为0.776,P值小于0.001),可用公式ARLV＝215.574+0.995×3 DCT-RLV,经t检验回归系数a、b均具有统计学意义,ta=3.942 P＜0.05,tb=12.126,P＜0.001.结论 肝移植术前MSCT对供体待移植肝脏的测量与排水法测得的真实体积呈正相关性,术前通过MSCT三维重建法测得的供体待移植肝体积,经过公式计算能够较准确提供供体真实肝移植体积值,为肝移植术前的手术方案的制定提供较准确的前瞻性依据.

Research on preoperative MSCT three-dimensional volume measurement of Donor's liver

Objective To investigate the relationship between the donor liver volume calculated by 16-slice multi-detector-row CT before living related liver transplantation (LRLT) and the hepatic volume measured during the operation,and try to get an equation to express the relation of associating the volume calculated by MSCT with the real volume of transplanted liver.Methods 100 donors of LRLT were enrolled to undergo 16-slice CT scanning at four enhancement phases.The imaging data at the hepatic venous phase was used for the prepared transplanted liver volume measurement on a dedicated image post-processing workstation.The resected part of donor liver was measured by Draining Method during the operation.Statistical analysis w as used to test the relationship between the MSCT measured liver volume and the actual volume of resected liver part,and the relationship w as expressed by scatter graph and linear equation.Results The mean of liver volumes calculated by MSCT before operation was 863.86±180.989ml,the mean volume of donated livers measured by Draining Method during operation was 651.67±141.222 ml,which were positively correlated((r=0.776,P<0.001),and could be expressed in the equation ARLV＝215.574+0.995×3 DCT-RLV,coefficient a and b are statistically significant by t test,ta=3.942 P＜0.05,tb=12.126,P＜0.001.Conclusion The donor liver volume calculated by MSCT preoperatively and the grafted liver Volume measured by Draining Method during the operation were significant positive correlated.We can use the equation to get the relatively real liver volume by the data provided by the MSCT.This method provides more accurate forward-looking basis for making the surgery program before the liver transplantation surgery.