多层螺旋CT半自动法测量肝体积在成人活体肝移植中的应用  

Application of semi-automated measurement of liver volume in living donor liver transplantation

作　　者：龚必焱[1] 季倩[1] 龙淼淼[1] 沈文[1] 祁吉[1] 

机构地区：[1]天津市第一中心医院,300192

出　　处：《中华器官移植杂志》2011年第2期108-111,共4页Chinese Journal of Organ Transplantation

摘　　要：目的探讨多层螺旋CT（MSCT）半自动法测量右半供肝体积的准确性，及该方法在活体肝移植（LDLT）中的应用价值。方法对56例供者术前行MSCT四期增强扫描，然后分别根据MSCT图像手动绘图（简称：手动法）计算右半供肝体积（V手）和应用IQQA -liver肝脏诊断辅助分析系统进行半自动化绘图（简称：半自动法）计算右半供肝体积（V半），将两种方法计算的右半供肝体积与术中经水置换法实测的右半供肝体积（V术）进行相关分析和Bland-Altman检查，得出其线性回归方程。结果v半、V手和V术分别为（818．60±161．43）、（880．16±169．92）和（669．84±141．37）cm^3；半自动法和手动法测量供肝体积与术中实测肝体积均显著相关（r值分别为0．778和0．746，P〈0．05），其线性回归方程分别为V术=V半×0．681＋112．26，V术=V手×0．620＋123．81。半自动法测量肝体积与术中实测肝体积的差值为148．76cm^3，95％可信区间为121．57～175．95cm^3，吻合限为-354．135-56．62cm^3，手动法测量肝体积与术中实测肝体积的差值为210．33cm^3，95%可信区间为180．09-240．56cm^3，吻合限为-438．66-18．01cm^3。结论半自动法测量LDLT右半供肝体积比目前最常用的手动法更为准确。Objective To evaluate the accuracy of multi-detector spiral CT （MSCT） semiautomated volumetric measurement of right lobes and its value in living donor liver transplantation （LDLT）. Methods Fifty-six donors underwent four phases MSCT. Pre-operative liver volumes of two measurements [IQQA -liver semi-automated （Vs） and manual volume （Vm） measurements] in portal vein phase were compared with intra-operative measurement （Vio） by means of water displacement. Results Correlation analysis and Bland-Altman tests were used for statistical analysis. Results Pre-operative measurements of grafts resulted in a mean Vs, Vm, Vio of （818. 60 ± 161.43） cm^3, （880. 16 - 169. 92） cm^3 and （669. 84 ± 141.37） cm^3 respectively. All corresponding pre- and intra-operative data were correlated significantly with each other. There was a good correlation between Vsand Vio（r= 0. 778, P〈0. 05）, so did Vm and Vio（r= 0. 746, P〈0. 05）. The equations of linear regression were Vio = Vs × 0. 681 ± 112. 26, and Vio = Vm × 0. 620 ± 123. 81 respectively. Exact 95 % CIs and the extent of concordance were 121.57-175. 95 cm^3 , - 354. 135-56. 62 cm^3 for semi- automated measurements, and 180. 09-240. 56 cm^3 , - 438. 66-18. 01 cm^3 for manual measurements, respectively. Conclusion Semi-automated method for the volumetric measurements of the right liver lobes in LDLT is more accurate than the manual method.

关 键 词：肝移植 活体供者 肝体积 体层摄影术 螺旋计算机 

分 类 号：R657.3[医药卫生—外科学]