活体肝移植供体术前肝脏CT测量体积与术中肝脏质量的关系研究

Research on Relationship between Preoperative CT Volumetry of Donor’s Liver and Intraoperative Weight Measurement of Liver for Living Related Liver Transplantation

目的应用多排螺旋CT对活体肝移植供体肝脏进行术前CT体积测量,探讨术前测量体积和术中测得移植肝质量之间的相关关系。方法对21例活体肝移植供体采用16层螺旋CT进行肝脏的四期增强CT扫描,在后处理工作站上测量肝静脉期图像供体全肝及部分肝体积。手术中对切下的移植部分肝脏称重。用统计学方法对CT测量的移植肝脏体积和手术中称重的移植肝质量进行分析,计算出回归直线,结果用散布图进行描述。结果术前CT测量的移植肝体积为(699.47±140.18)mL,术中测得的移植肝质量为(532.14±98.01)g,二者成正相关(r=0.848,P<0.001),可用公式W术中(g)=0.593×V术前(mL)+117.229来表示。结论供体移植肝术前CT测量体积与术中移植肝质量之间存在正相关,术前可通过公式比较准确地计算出对应的移植肝质量,为供体的选择和制定恰当的手术方案提供重要依据。

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 weight measured during the operation, and try to get an equation to express the relation of associating volume with weight of transplanted liver. Methods 21 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 whole and partial liver volumetry processed or measured on a dedicated image post-processing workstation. The resected part of donor liver was weighed during the operation. Statistical analysis was used to test the relationship between the CT-measured liver volume and the actual weight of resected liver part, and the relationship was expressed by scatter graph and linear equation. Results The mean of liver volumes calculated by CT before operation was （699. 47± 140. 18） mL, the mean weight of donated livers measured during operation was （532. 14±98.01） g, which were positively correlated （P〈 0. 001）, and could be expressed in the equation W（g）= 0. 593 × V （mL）＋ 117. 229. Conclusion The correlation equation between the donor liver volume calculated by CT preoperatively and the grafted liver weight measured during operation can be used to accurately estimate the desired liver mass for LRLT, which is very helpful for donor selection and preoperative planning.