多层螺旋CT检查肝脏体积对乙型肝炎肝硬化患者肝脏受损程度的量化诊断价值分析  

Quantitative diagnosis of liver functions in patients with liver cirrhosis by multi-slice spiral CT-calculated liver volume

作　　者：龚怡 付倩 张蓓[2] Gong Yi;Fu Qian;Zhang Bei(Department of Radiology,Shanghai Hospital of Civil Aviation,Shanghai 200336)

机构地区：[1]民航上海医院放射科,上海市200336 [2]上海交通大学附属瑞金医院放射科

出　　处：《实用肝脏病杂志》2018年第6期895-898,共4页Journal of Practical Hepatology

基　　金：上海市科技创新计划项目(编号:12456671403)

摘　　要：目的探讨应用多层螺旋CT肝脏扫描计算肝脏体积对乙型肝炎肝硬化患者肝脏受损程度的量化诊断价值。方法 2015年4月～2017年4月在我院接受CT检查的乙型肝炎肝硬化患者70例,常规进行肝功能Child-Pugh分级和终末期肝病模型(MELD)评分。根据公式计算肝脏理论体积,将CT扫描得到的肝脏CT原始图像导入Mimics10.01软件,计算肝脏实际体积。结果 28例Child-Pugh C级患者肝脏CT实测体积为(712.07±65.89)cm^3,25例B级患者为(832.17±80.46) cm^3,17例A级患者为(992.51±299.02) cm^3,均显著小于理论体积[分别为(1415.74±126.81) cm^3、(1458.29±164.17) cm^3和(1498.93±114.39) cm^3, P<0.05]; 22例MELD评分≥20患者肝脏CT体积为(757.83±39.04) cm^3,和30例20>MELD评分≥10患者肝脏CT体积为(813.84±80.97) cm^3,18例MELD评分<10分患者肝脏CT体积为(982.09±281.75)cm^3,均显著小于肝脏理论体积[分别为(1461.57±65.23)cm^3、(1481.19±155.85) cm^3和(1482.12±87.26)cm3,P<0.05]。结论多层螺旋CT扫描计算肝脏体积可作为判断乙型肝炎肝硬化患者肝脏受损程度的一个量化指标,具有重要的临床意义。Objective To investigate the quantitative diagnosis of liver functions in patients with liver cirrhosis by multi-slice spiral CT-calculated liver volume.Methods 70 patients with liver cirrhosis were recruited in this study between April 2015 and April 2017,and all the patients received multi-slice spiral CT examination.The theoretical and practical liver volumes were calculated according to the reported methods.Results The CT-determined practical liver volumes in 28 patients with Child-Pugh class C,25 with class B and 17 with class A were(712.07±65.89)cm3,(832.17±80.46)cm3 and(992.51±299.02)cm3,much lower than the theoretical liver volumes[(1415.74±126.81)cm3,(1458.29±164.17)cm3 and(1498.93±114.39)cm3,respectively,P≤0.05];the CT liver volumes in 22 patients with MELD score≥20,in 30 with 20>MELD score≥10 and 18 with MELD score<10 were(757.83±39.04)cm3,(813.84±80.97)cm3 and(982.09±281.75)cm3,significantly lower than the theoretical liver volumes[(1461.57±65.23)cm3,(1481.19±155.85)cm3 and(1482.12±87.26)cm3,respectively,P≤0.05].Conclusions Multi-slice spiral CT-calculated liver volume might be used as a quantitative diagnosis of liver functions in patients with hepatitis B cirrhosis.

关 键 词：肝硬化 多层螺旋CT 肝脏体积 肝功能分级 

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