活体肝移植术前CT测量供体肝右叶体积和重量的校正公式

Amending Formulae for the Calculation of Right Liver Lobe Volume and Weight by CT in Donors before Living Donor Liver Transplantation

目的:为能通过活体肝移植(LDLT)术前CT测得的肝右叶体积(RLV)精确预测其实际体积和重量而建立公式。方法:78例供体在右半肝移植术前进行增强CT扫描,利用CT测量RLV,术中再分别测量实际切下的RLV和肝右叶重量(RLW)。用统计学方法对CT测得值和术中测得值之间关系进行分析,计算直线回归方程,利用该方程校正CT预测值,比较校正前后预测值的准确性。结果:术前CT测得的肝右叶体积(RLV-CT)为(777.3±108.8)ml,术中测得的肝右叶体积(RLV-Intraop)为(689.1±97.7)ml,两者呈正相关(r=0.882,P<0.001),术中测得的肝右叶重量(RLW-Intraop)为(741.6±98.0)g,亦与RLV-CT亦呈正相关(r=0.909,P<0.001),可分别用公式RLV-Intraop(ml)=0.792×RLV-CT(ml)+73.771和RLW-Intraop(g)=0.819×RLV-CT(ml)+104.885来表示。CT测得的未经上述公式校正的RLV或移植肝体积和受体标准肝体积之比、RLW或移植肝重量和受体体重之比的准确率分别为11.5%和48.7%,明显低于校正后的50%和71.8%(P值均<0.05)。结论:LDLT术前运用上述公式校正RLV-CT后,可以更准确地预测潜在右叶供肝的体积和重量。

Objective：To develop equations for the accurate calculation of actual weight and volume of a living donor′s right liver lobe by using CT for volumetric measurement before living donor liver transplantation（LDLT）.Methods：78 donors underwent contrast enhanced CT scan before right lobe LDLT,and their right lobe volume（RLV） was measured.The actual right lobe weight（RLW） and RLV of the resected graft were estimated intra-operation.Statistical analysis was used to evaluate the relationship between the values calculated by CT and the real value assessed intra-operation.Linear regression formulae were calculated.The accuracy of values predicted by CT was compared before and after amendment by above formulae.Results：Preoperative measurement of RLV by CT（RLV-CT） resulted in a mean volume of（777.3±108.8）ml,the mean intra-operation RLV（RLV-Intraop） was（689.1±97.7）ml.RLV-CT and RLV-Intraop were positively correlated（r=0.882,P〈0.001）.Intra-operation RLW measured（RLW-Intraop） was（741.6±98.0）g.There was significant correlation between RLV-CT and RLW-Intraop（r=0.909,P〈0.001）.The relationships between RLV-CT and RLV-Intraop and RLW-Intraop could be expressed in the equations：RLV-Intraop（ml）=0.792×RLV-CT（ml）＋73.771 and RLW-Intraop（g）=0.819×RLV-CT（ml）＋104.885,respectively.The accuracy of RLV-CT or graft volume/standard liver volume ratio（GV/SLV）,and RLW or the graft recipient weight ratio（GRWR） before amendment by formulae were 11.5% and 48.7% respectively,which was significantly lower than 50% and 71.8% after amendment,respectively（P〈0.05）.Conclusion：After amending RLV-CT by two equations established in this study,actual weight and volume of potential graft can be determined more accurately before LDLT.