乙肝肝硬化患者肝体积的多层螺旋CT测量及与Child-Pugh分级的相关性

Correlation Analysis of MSCT in Liver Volume Measurement and Child-Pugh Grade of Hepatitis B Cirrhosis

目的探讨乙肝肝硬化患者随着硬化严重程度的增加,肝脏各叶及肝脏总体积的变化规律。方法选择在我院行上腹部增强CT扫描的乙肝肝硬化住院患者101例,Child-Pugh A级31例,Child-Pugh B级42例,Child-Pugh C级28例,平均年龄52.72岁,对照组为同期98例无肝脏基础疾病,因其他原因行上腹部CT增强扫描的受检者,平均年龄51.73岁。采用Syngo Acquisition工作站的Volume软件分别测量肝脏各叶体积。结果肝硬化Child-Pugh各分级患者的肝脏左外叶体积均大于对照组,Child-Pugh A级大于B级(P<0.05);肝硬化Child-Pugh各分级患者左内叶、右前叶体积较对照组缩小(P<0.05);Child-Pugh A、B级肝硬化右后叶体积较对照组缩小(P<0.05);尾状叶体积Child-Pugh A、C级较对照组增大(P<0.05);总肝体积Child-Pugh B、C级小于对照组(P<0.05)。结论乙肝肝硬化患者肝脏左外叶及尾状叶增大,左内叶、右前叶、右后叶及肝脏总体积缩小,但肝脏各叶体积变化与肝功能异常程度并不完全一致。

Objective To analyze the correlation of MSCT in liver volume measurement and Child- Pugh grade about hepatitis B cirrhosis. Methods 101 cases with cirrhosis of hepatitis B were recruited. all subjects were divided into three groups: Child- Pugh A 31 cases,Child- Pugh B 42 cases and Child- Pugh C28 cases. Control group were 98 adults having neither liver disease( 44 males and 54 females) nor other diseases leading to liver volume change. All subjects underwent 64 spiral CT enhancement coefficient of male rats in long term UVB and high temperature exposure group were also significantly lower than those in control group. The level of IL- 1 in serum of male rats in long term UVB and high temperature exposure group was significantly lower than those in control group( P < 0. 05) while the level of IL- 2 and examination. The margins of liver lobe was outlined manually using volume analysis software of Syngo Acquisition workstation,and the volume of the liver lobe was calculated automatically by software.Results Left lateral lobe and caudate lobe of cirrhosis liver was significantly bigger than that of normal liver( P < 0. 05),however,the medial segment of liver left lobe,right anterior lobe,right posterior lobe and total liver of cirrhosis liver were significantly smaller than those of normal liver( P < 0. 05). The significant hyperplasia of left lateral lobe was in Child- Pugh A and the medial segment of liver left lobe volume reduced with the liver function severity while the significant atrophy of right posterior lobe was in Child- Pugh B and the significant hyperplasia of caudate lobe were Child- Pugh A and C. There was negative correlation between total liver volume and Child- Pugh score( r =- 0. 223,P = 0. 025). Conclusion In short,compared with normal liver,the cirrhosis of hepatitis B liver's left lateral lobe and caudate lobe is hyperplasia and medial segment of liver left lobe,right anterior lobe,right posterior lobe and total liver volume is atrophy. However,changes in the lobes of volume and the degree of liver function is not completely consistent.