CT五点法测量肝硬化腹水定量的初步研究  

Preliminary Study on the Quantitative Measurement of Ascites Due to Cirrhosis by CT Five-point Method

作　　者：徐占国[1] 任津瑶[2] 亓俊霞[1] 于长路[1] 

机构地区：[1]天津市第三中心医院医学影像科,天津300170 [2]天津医学高等专科学校医疗技术系,天津300222

出　　处：《继续医学教育》2017年第8期141-143,共3页Continuing Medical Education

摘　　要：目的为评估肝硬化腹水患者对治疗的确切反应,腹水量的客观测量至关重要。利用CT五点法来测量肝硬化患者的腹水量,通过与应用3D-CT的标准体积计算方法的比较来验证测量的准确性。方法 58例肝硬化腹水患者接受100次螺旋CT检查。在常规的CT图像上分布在3个层面上测量腹水的厚度(cm),这3个层面分布位于双侧膈下间隙水平(A、B)、双侧结肠旁间隙水平(C、D)、膀胱前间隙水平(E),并计算出平均厚度:(A+B+C+D+E)/5。然后将平均厚度乘以腹腔前后位投影的标准面积,该面积假定为1 000 cm^2,由此计算出腹水体积(A+B+C+D+E)/5×1 000(ml)。将计算出的腹水体积与通过3D-CT以容积重建方法获得的精确体积进行比较。结果通过五点法和通过容积重建方法测得的腹水体积范围分布为314~5 868ml和340~5 144 ml,两者之间差异无统计学意义(P>0.05)。结论这项初步研究表明,这种常规CT的五点测量方法是准确的。因为该方法简单易行,可以应用于治疗后的腹水检测随访。Objective To assess the exact response of the hepatic cirrhosis ascites to the treatment,the objective measurement of the volume of ascites is essential.To measure the volume of hepatic cirrhosis ascites by CT Five-point method.The aim of the study is to validate the accuracy of the measurements by comparing them with the standard volume calculation by using 3D-CT.Methods Fifty-eight patents with hepatic cirrhosis had underwent 100 helical CT examinations.On conventional CT images,the thickness of ascites in centimeters was measured in three planes such as the bilateral subphrenic space（A and B）,the bilateral paracolic space（C and D） and the pre-bladder space（E）,and the average thickness：（A＋B＋C＋D＋E）/5 was then multiplied by the area of standard abdominal cavity in the anterior projection,that was assumed to be 1 000 cm^2,to yield the volume of ascites：（A＋B＋C＋D＋E）/5×1 000（ml）.The volume of ascites was compared with the exact volume,that was obtained from 3D-CT with the volume rendering method.Results The volume of ascites measured by the present method and the volume rendering method ranged from 314 to 5 868 ml and from 340 to 5 144 ml,and there was no significant difference between them（P〉0.05）.Conclusion The preliminary study indicates that the present fivepoint method using a conventional CT is accurate.Because this procedure is simple and easy to perform,it should be feasible in many hospitals for the follow-up of ascites after treatment.

关 键 词：肝硬化 腹水 计算机断层扫描 

分 类 号：R445.3[医药卫生—影像医学与核医学]