目的 探討用個(gè)人電腦及自行開(kāi)發(fā)的軟件對(duì)肝臟CT斷層圖像進(jìn)行三維重建和測(cè)量及其在肝硬變門(mén)靜脈高壓癥患者中的臨床意義。方法 術(shù)前對(duì)46例行原位肝移植的肝硬變門(mén)靜脈高壓癥患者和30例正常對(duì)照者的肝臟CT斷層圖像進(jìn)行三維重建和測(cè)量，術(shù)后與肝硬變門(mén)靜脈高壓癥患者切除的受體實(shí)測(cè)肝體積進(jìn)行對(duì)比分析。 結(jié)果 46例肝硬變門(mén)靜脈高壓癥患者用本方法測(cè)得平均肝臟體積為(983.33±206.11) cm3，同組實(shí)測(cè)平均肝臟體積為(904.93±209.56) cm3，二者之間呈高度正相關(guān)(r=0.969, P＜0.01），本方法測(cè)定值的平均誤差為8.66%。正常對(duì)照組用本方法測(cè)得平均肝臟體積為(1 287.00±96.18) cm3, 與其身高、體重和體表面積之間均存在著正相關(guān)關(guān)系(r值分別為0.845、0.833和0.932,P＜0.01）。肝硬變門(mén)靜脈高壓癥患者肝臟體積與ChildPugh分級(jí)有關(guān), C級(jí)患者肝臟體積明顯小于B級(jí)者； 也與血漿白蛋白水平呈顯著正相關(guān)（r＝0.496,P＜0.01），與總膽紅素水平（r＝-0.493,P＜0.01）及凝血酶原時(shí)間(r＝-0.517,P＜0.01）呈顯著負(fù)相關(guān)，與ALT值（r＝0.206，P gt;0.05）、門(mén)靜脈壓力（r＝-0.093，P＝0.539）及門(mén)體自然分流指數(shù)(r＝0.044，P＝0.769)無(wú)明顯相關(guān)關(guān)系。 結(jié)論 運(yùn)用該方法對(duì)肝臟CT斷層圖像進(jìn)行三維重建和測(cè)量準(zhǔn)確性較高。肝臟體積大小與肝功能有密切關(guān)系，肝臟體積可較敏感地反映肝臟儲(chǔ)備功能狀況。
引用本文： 王茂春,冷希圣,彭吉潤(rùn),朱繼業(yè),杜如昱. 肝硬變門(mén)靜脈高壓癥患者肝體積測(cè)量研究及其臨床意義. 中國(guó)普外基礎(chǔ)與臨床雜志, 2003, 10(6): 586-588. doi: 復(fù)制
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- 2. Albers I,Hartmann H, Bircher J, et al. Superiority of the ChildPugh classification to quantitative liver function tests for assessing prognosis in liver cirrhosis [J].Scand J Gastroenterol, 1989; 24(3)∶269.
- 3. Galambos JT. Evaluation of patients with portal hypertension [J].Am J Surg, 1990; 160(1)∶14.
- 4. Zoli M, Cordiani MR, Marchesini G, et al. Prognostic indicators in compensated cirrhosis [J].Am J Gastroenterol, 1991; 86(10)∶1508.
- 5. 胡永梅，武曉洛，胡志紅，等. 關(guān)于中國(guó)人體表面積公式的研究 [J].生理學(xué)報(bào)， 1999; 92(1)∶45.
- 6. Redvanly RD, Nelson RC, Stieber AC, et al. Imaging in the preoperative evaluation of adult livertransplant candidates: goals,merits of various procedures, and recommendations [J].AJR Am J Roentgenol, 1995; 164(3)∶611.
- 7. Ogasawara K, Une Y, Nakajima Y, et al. The significance of measurring liver volume using computed tomographic images before and after hepatectomy [J].Surg Today, 1995; 25(1)∶43.
- 8. Ros PR, Elrahman MM, Barreda R, et al.Threedimensional imaging of liver masses: preliminary experience [J]. Appl Radiol, 1990; 19(1)∶28.
- 9. Heymsfield SB, Fuleonwider T, Nordlinger B, et al. Accurate measurement of liver, kidney and spleen volume and mass by computerized axial tomography [J].Ann Intern Med, 1979; 90(2)∶185.
- 10. Van Thiel DH, Hagler NG, Schade RR, et al.In vivo hepatic volume determination using sonography and computed tomography [J].Gastroenterology, 1985; 88(6)∶1812.
- 11. Caldwell SH, de Lange EE, Gaffey MJ, et al. Accuracy and significance of pretransplant liver volume measured by magnetic resonance imaging [J]. Liver Transpl Surg, 1996; 2(6)∶438.
- 12. Fritschy P, Robotti G, Schneekloth G, et al. Measurement of liver volume by ultrasound and computed tomography [J]. J Clin Ultrasound, 1983; 11(6)∶299.