多层螺旋CT测量肝体积的实验和临床研究及对肝移植的应用价值

Study of liver volume measurement and its clinical application for liver transplantation using multiple-slice spiral CT

目的 研究多层螺旋CT(MSCT)测量肝体积的准确度及对肝移植的应用价值。方法(1)实验研究。MSCT扫描 10只猪肝 ,3 2、6 5mm层厚扫描 ,半自动方法重建肝脏三维模型 ,计算体积。 (2 )临床研究。 2 3例肝移植术前MSCT扫描 ,6 5mm层厚 ,方法同前。同一观察者相隔 1个月重复测量。结果 (1)实验研究。测得猪肝实际体积平均为 (1134 1± 2 88 0 )ml,3 2、6 5mm厚测量肝体积为 (112 5 0± 2 82 5 )ml、(110 1 6± 2 77 6 )ml,准确度为 (99 5± 0 8) %、(97 4± 0 8) % ,与实际肝体积比较 ,r值均为 0 999,P <0 0 1。 (2 )临床研究。术后测得实际肝体积平均为 (14 5 5 7±730 0 )ml,术前CT测量 2 3例肝体积平均为 (14 6 2 7± 774 1)ml,准确度 (99 5± 9 6 ) % ,r =0 986 ,P <0 0 1。同一观察者重复测量平均为 (14 4 9 4± 76 8 9)ml,两次测量结果间比较 ,r =0 991,P <0 0 1。结论 MSCT测量肝体积有较高的准确度和可重复性 ,是肝移植术前检查的重要组成部分。

Objective To study the accuracy of liver volume measurement using MSCT and its application in liver transplantation.Methods (1) Experimental study.Ten pig livers were scanned using MSCT with two collimations (3.2 mm and 6.5 mm) and pitch 1.25.Semi-automatic method was used to reconstruct 3D liver models to measure the liver volume.(2) Clinical study.Twenty-three patients received MSCT scan with collimation of 6.5 mm before liver transplantation.Same method was used to calculate the liver volume and the measurement was repeated by the same observer after 1 month.Results (1) Experimental study.Actual liver volumes were (1134.1±288.0) ml.Liver volumes by MSCT with two collimations were (1125.0±282.5) ml (3.2 mm) and (1101.6±277.6)ml (6.5 mm).The accuracy was (99.5±0.8)% and (97.4±0.8)%,respectively.Both showed same good agreement with actual liver volume: r=0.999, P<0.01.(2) Clinical study.Actual liver volumes were (1455.7±730.0) ml.Liver volume by MSCT was (1462.7±774.1) ml.The accuracy was (99.5±9.6)%,r=0.986,P<0.01.Liver volume measured again was (1449.4±768.9) ml,r=0.991 (P<0.01).Conclusion MSCT can assess the liver volume correctly,and could be used as a routine step for evaluations before liver transplantation.