iCT肝脏分段及体积测量与乙肝肝硬化患者Child、MELD评分的相关性研究  

The correlation among the liver segment's volume,Child score and MELD score on patients with hepatitis B-related hirrhotic by the iCT

作　　者：陈大治[1,2] 谭辉 樊秋菊[1,2] 哈若水[1,2] 

机构地区：[1]宁夏人民医院医学影像中心,宁夏银川750002 [2]北方民族大学教学合作医院,宁夏银川750002 [3]陕西省中医药大学附属医院放射科,陕西710000

出　　处：《宁夏医学杂志》2017年第8期688-690,共3页Ningxia Medical Journal

基　　金：宁夏自然科学基金项目(NZ14291)

摘　　要：目的探讨全肝及各肝段体积与乙肝肝硬化患者肝功能Child、MELD评分的相关性,分析不同MELD评分在肝硬化患者各肝段体积的变化规律。方法 52例肝硬化患者和48例正常组对照,应用iCT专用软件测量肝脏总体积及各肝段体积,计算得到标准化后总肝体积(SLV),研究SLV与Child、MELD评分的相关性;依据MELD评分将肝硬化组分为3组,分析各组与正常组各肝段体积的变化规律。结果 SLV与Child、MELD评分均呈负相关性(P<0.05),与对照组相比,SⅠ在组1、组2中绝对体积及占全肝体积百分比均增大,在组3中绝对体积减小,占全肝体积百分比增大;SⅡ、SⅢ在组1、组2中绝对体积及占全肝体积百分比均增大,在组3中绝对体积减小,占全肝体积百分比增大;SⅣ绝对体积随MELD评分分值增加逐渐减小,其占全肝体积百分比的变化差异无统计学意义;SⅤ、SⅥ在组1中绝对体积及占全肝体积百分比的变化差异无统计学意义,在组2、组3中绝对体积减小且差异有统计学意义;SⅦ、SⅧ在3组中绝对体积及占全肝体积百分比均减小且差异有统计学意义。结论肝硬化患者SLV与MELD评分具有更好的相关性,且肝脏体积呈不对称性缩小;应用iCT不仅可以观察肝硬化患者肝脏整体及各段形态学变化规律,还能较精确评估肝脏储备功能,对判断疾病进展及预后具有较好的临床意义。[ Abstract] Objective To investigatethe relationship beween the volume of the whole liver and the segmental livers and the score of Child and MELD in the hepatitis patients with cirrhosis liver inorder to analyze the regular chage of liver segment in different MELD score. Methods 52 patients with liver cirrhosis and 48 cases as normal control group were selected, iCT proprietary software were used to measure the volume of the whole liver and the segmental livers and calculate the total liver volume （SLV）, standardized research SLV and Child,the correlation of MELD score. According to the MELD score,the cirrhosis group was divided into three groups, and the variation of groups were analyzed. Results SLV had the negative correlation with the Child and MELD score （ P 〈 0.05 ）. Compared with control group： Slwas increased in the absolute volume of group land group 2,just as the ratio of liver volume. The absolute volume in group 3 was de- creased, but the ratio of the liver volume was increased. SⅡ and SⅢ were increased in the absolute volume of group 1 and group 2 ,just as the ratio of liver volume. The absolute volume in group 3was decreased,but the ratio of the liver volume was increased;with MELD score in- creased,SIV absolute volume gradually decreased. The change of liver volume percent was no statistical difference;SⅤ, SⅥ of the absolute volume in group 1 and accounts for the change of liver volume percent were no statistical difference,but in group 2 and group 3 the absolute volume decreased and had the statistically significant ;SⅦ,SⅧ in three groups of absolute volume and volume percentage of liver were de- creased and had statistically significant. Conclusion The SLV and MELD score of liver cirrhosis are more relevant and the liver volume is asymmetrical and narrow. The application of iCT can not only observed in patients with liver cirrhosis and whole segmental morphology change but also can more accurately assess the liver reserve function in order to estimate disease progression.

关 键 词：256层iCT 肝硬化 Couinand分段 Child评分 

分 类 号：R512.62[医药卫生—内科学] R575.2[医药卫生—临床医学] R816.5