128层MSCT测量肝脏体积在肝巨大血管瘤精准切除中的应用研究  

Study on liver volume measurement with 128-slice MSCT in precise hepatectomy on patients with huge hemangioma

作　　者：刘力[1] 金梅[1] 曹大勇 林奕军 高振兴[1] 于晓明[1] LIU Li;JIN Mei;CAO Dayong;LIN Yijun;GAO Zhenxing;YU Xiaoming(CT Room,No 1 Hospital of Municipal Qiqihar,Qiqihar 161005,P.R.China;Departments of General Surgery,No 1 Hospital of Municipal Qiqihar,Qiqihar 161005,P.R.China)

机构地区：[1]黑龙江省齐齐哈尔市第一医院CT室,黑龙江齐齐哈尔161005 [2]黑龙江省齐齐哈尔市第一医院普外二科,黑龙江齐齐哈尔161005

出　　处：《医学影像学杂志》2018年第7期1130-1133,共4页Journal of Medical Imaging

基　　金：黑龙江省齐齐哈尔市科学技术计划指导项目(编号:SFZD-2016066)

摘　　要：目的探讨128层螺旋CT肝脏体积测量对肝巨大血管瘤行精准肝切除的价值。方法选取2016年1月~2017年12月临床拟诊肝巨大血管瘤患者28例,术前均行CT常规平扫+肝脏三期增强扫描,将薄层图像传至GE AW4.6后处理工作站,采用肝脏体积测量软件(Volume),分析肝巨大血管瘤的位置、大小与周围血管的毗邻关系,从而生成全肝体积和肝血管瘤体积。经CT医师与普外科医师商讨制定手术方案,分析预切除肝体积,将手术标本采用水测法得出切除标本的总体积。将预切除肝体积与手术标本体积间进行线性相关分析。运用SPSS 20.0对所得数据进行t检验及相关分析。结果 28例患者中,肝脏海绵状血管瘤22例,硬化性血管瘤3例;血管内皮细胞瘤2例;毛细血管瘤1例。预切除肝脏体积介于(1650.52±475.90)cm3,手术标本体积介于(1670.64±420.25)cm3,两者间差异无统计学意义(P=0.213)。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=0.232)。按照术前制定的手术切除方案,所有肝血管瘤均完整切除。预切除肝体积与手术标本体积间相关性显著,相关系数为0.924。结论 128层MSCT肝脏体积测量可作为普外科施行精准肝切除的重要影像学依据,并提供个体化指导。Objective To evaluate the value of the liver volume measurement with 128-slice MSCT in precise hepatectomy on patients with huge hemangioma.Methods 28 patients with huge hepatic hemangioma from January 2016 to December 2017 were collected for clincal examination. All patients underwent routine 128-slice MSCT scan and three-phase enhanced scan of liver before the surgery. Then, the thin layer images were transferred to GE AW4.6 post-processing workstation. The volume measurement software was used to analyze both location and size of the huge liver hemangioma and its adjacent relation around the vessel, which, in turn, generated the total liver volume and vlume of liver hemangioma. The CT physicians and the general surgeon discussed the operational plan, analyzed the pre-cut liver volume and obtained thetotal volume of the specimen by use of the water method. The linear correlation between the volume of the l-iver and the volume of the surgical specimen was analyzed. SPSS 20.0 was employed to perform t test and correlation analysis.Results There were 22 cases of cavernous hemangioma of the liver, 3 cases of sclerosing hemangioma, 2 cases of vascular endothelioma and 1 case of capillary tumor. The volume of the liver was in the range of （1650.52±475.90） cm^3. The volume of the surgical specimen was in the range of （1670.644±20.25） cm^3, and the difference was not statistically significant （ P =0.213）. There was no significant difference between preoperative preoperative volume percentage and postoperative specimen （ P =0.232）. All hepatic hemangiomas were resected according to surgical resection. The volume of the liver was significantly related to the volume of the surgical specimen （coefficient factor=0.924）.Conclusion The 128-slice MSCT’s liver volume measurement can provide an important imaging basis for precise liver resection in general surgery and provide individualized guidance.

关 键 词：肝脏血管瘤 体积测量 精准肝切除 体层摄影术 X线计算机 

分 类 号：R735.7[医药卫生—肿瘤] R814.42[医药卫生—临床医学]