16层螺旋CT容积扫描在肝硬化患者Child-Pugh分级中的应用

Application value of volume measurement by 16-slice spiral CT in patients with different Child-Pugh classes of hepatic cirrhosis

目的探讨16层螺旋CT测量肝叶体积与肝硬化严重程度之间的关系,以及在肝硬化患者中的应用。方法选取肝硬化患者(观察组)及健康体检者(对照组)各120例,行16层螺旋CT容积扫描,分别测量肝脏左外叶、方叶、右叶、尾叶及全肝的体积。结果观察组患者除肝尾叶外,其余各个肝叶的体积和全肝体积与正常对照组比较,差异均有统计学意义(P<0.05)。Child-Pugh分级越高,肝左外叶、肝方叶、肝右叶和全肝的体积越小(rY1=-0.357,P<0.05);肝尾叶体积与Child-Pugh分级无关(P>0.05)。结论 16层螺旋CT能准确地测量肝脏及各肝叶的体积,其大小与肝硬化严重程度有一定相关性,将Child-Pugh分级与肝叶体积测量有机地结合起来,更有利于准确评价肝脏潜在的储备能力。

Objective To investigate the relationship between degree of hepatic cirrhosis and volumes of liver lobes measured by 16-slice spiral CT in order to determine the application value of the 16-slice spiral CT in hepatic cirrhosis. Methods One hundred and twenty patients with hepatic cirrhosis（ observation group）and 120 healthy people who underwent health examination（ control group） were selected and underwent volume scan by 16-slice spiral CT. The volumes of the Couinaud, quadrate lobe, right lobe, caudal lobe and the whole liver were measured, respectively. Results Except the volume of the caudate lobe, the differences in volumes of the other parts of liver and the whole liver between the observation and control groups were statistically significant（P 〈 0.05）. In patients with hepatic cirrhosis,the volumes of Couinaud, quadrate lobe, right lobe and whole hver were negatively correlated with Child-Pugh classifi- cation（ rY1 =-0. 357 ,P 〈 0.05 ）. However, the volume of caudal lobe was not correlated with the classification. Conclusions 16- slice spiral CT can accurately measure the volumes of liver and each lobe of liver. The volumes are correlated with the severity degree of hepatic cirrhosis. Child-Pugh classification combined with volume measurement of liver lobes can more accurately evaluate the liver reserve ability.