256层MSCT肝脏体积测量在肝肿瘤行精准肝切除中的初步应用  

Preliminary Application of 256 Slice MSCT Hepatic Volume Measurement in Precise Liver Resection of Hepatic Tumors

作　　者：王均干[1] 侯海燕[1] 姜建威[1] 金成[2] 殷允娟[1] 

机构地区：[1]江苏省无锡市第三人民医院影像中心,无锡214041 [2]江苏省无锡市第三人民医院肝胆外科,无锡214041

出　　处：《中国现代手术学杂志》2015年第6期471-474,共4页Chinese Journal of Modern Operative Surgery

摘　　要：目的探讨256层CT肝脏体积测量对肝肿瘤行精准肝切除的指导价值。方法2012年1月~2014年6月收集临床拟诊肝肿瘤患者16例,术前均行256层MSCT常规平扫＋双期增强扫描,将门脉期薄层图像传至后处理工作站,应用肝脏体积测量软件（Liver）,分析肝肿瘤的位置大小与周围血管的空间位置关系,并生成全肝体积和肝肿瘤体积。经影像科医师与外科医师共同讨论制定可能的手术方案,分析预切除肝脏体积,将手术标本采用水测法得出切除标本的总体积。将预切除肝脏体积与手术标本体积间进行线性相关分析。结果本组16例患者中,原发性肝癌13例,结肠癌术后转移性肝癌1例,肝脏血管瘤2例。预切除肝脏体积介于（170.53±175.91）ml,手术标本体积介于（143.67±120.15）ml,两者间差异无统计学意义（P=0.216）。术前预切除体积百分比与术后标本比较,差异无统计学意义（P=0.234）。依据术前制定的手术切除方案,所有肿瘤均得以完整切除。预切除肝脏体积与手术标本体积间明显相关（相关系数为0.921）。结论 256层MSCT肝脏体积测量可以为临床施行精准肝切除提供个体化指导的影像学依据。Objective To explore the guiding value of 256 slice MSCT hepatic volume t of hepatic tumor for precise liver resection. Methods 16 patients diagnosed as hepatic tumors underwent the plain and double-phase contrast-enhanced scans by 256 slice MSCT, the thin slice images of the portal phase were transferred into the software for hepatic volume measurement, the location and size of tumors and the space relationship with surrounding vessels were all analyzed. After the whole liver volume and the tumor volume measured, the possible surgery plans were discussed and made by the radiologist and hepatobiliary surgeon. The predictive resection volume were measured and statistically analyzed with that of operative specimen according to water measurement method. Results Out of the 16 hepatic tumor cases, there were 13 cases of primary he- patic carcinomas, 1 case of metastatic carcinoma due to colon carcinoma and 2 cases of hepatic hemangioma. The volume of the predictive liver resection and the operative specimen was （ 170.53 ± 175.91 ） ml and （ 143.67 ± 120.15）ml respectively, and there was no statistical difference （t = 1. 294, P = 0. 216）. No statistical difference was found between the percentage of the predictive volume and the operative specimen volume （X2 =210, P =0. 234）. According to the operative resection plan, all tumors were resected completely. The predictive hepatic volume had good correlation with that of surgical specimen （ coefficient factor = 0. 921 ）. Conclusion The 256 slice MSCT hepatic volume measurement could provide individual guidance for precise resection of hepatic tumors.

关 键 词：体积测量 肝 精准肝切除 体层摄影术 螺旋计算机 肝肿瘤 

分 类 号：R735.7[医药卫生—肿瘤] R730.44[医药卫生—临床医学]