兰州大学机构库 >学院待认领
活体肝移植术前64层螺旋CT肝体积评估的实验和临床研究
Alternative TitleExperimental and clinical study of preoperative liver volume evaluation in living donor liver transplantation with 64-slice spiral CT
周星
Thesis Advisor周怀琪
2009-05-26
Degree Grantor兰州大学
Place of Conferral兰州
Degree Name硕士
Keyword肝脏体积 CT肝体积测量 实际肝体积 64层螺旋CT 活体肝移植
Abstract目的 探讨术前64层螺旋CT测量肝体积的准确性,分析CT测量肝体积与实际肝体积的关系及两者差异的原因,对活体肝移植术前肝体积进行更准确的评估。 方法 实验研究:选取健康家兔30只,随机分为实验组、对照组两组,均采用64层螺旋CT行兔肝三期增强扫描,在后处理工作站上分别测量门静脉期、肝静脉期1mm、3mm兔肝全肝体积。 实验组模拟供肝切除及灌洗过程后取出肝脏,对照组结扎血管后取出肝脏,利用排水法、称重法测量两组实际肝体积及重量。 分析CT测量肝体积与实际肝体积的关系,获得回归直线公式。临床研究:收集一例活体肝移植术前供体行两期增强扫描,在后处理工作站上测量门静脉期3mm全肝体积、包括肝中静脉右半肝体积、不包括肝中静脉右半肝体积,术中获得实际移植肝的重量和体积。利用现有的临床资料对回归直线公式进行验证。 结果 实验研究:实验组、对照组不同层厚、时相CT测量肝体积与实际肝体积呈正相关(r值均>0.975,P<0.001),实验组实际肝体积可分别用回归公式:实际肝体积(ml)=-9.619+ 0.925* CTLV –V 1mm(cm3);=-11.533 +0.941 * CTLV –V 3mm(cm3);=-13.766+0.977*CTLV-P1mm(cm3);=-12.242+0.942 * CTLV-P3mm (cm3)来表示。对照组实际肝体积可分别用回归公式:实际肝体积(ml)=0.016+ 0.954 *CTLV-V1mm(cm3);=1.553+0.910* CTLV- V3mm(cm3);=3.653 +0.901 *CTLV – P1mm(cm3); =8.552+0.988*CTLV-P3mm(cm3)。实验组、对照组不同层厚、时相CT测量体积与实际肝体积之间差异分别为20.2±0.5%、 6.29± 0.43%。实验组和对照组CT测量体积和实际肝体积差异有统计学意义 (F = 420.380,P<0.05)。不同层厚、不同时相CT测量体积和实际肝体积差异无统计学意义(F=3.038,P >0.05;F=0.024,P>0.05),实验组、对照组肝脏密度分别为1.000 ± 0.011g/ml、1.003±0.007 g/ml。两组肝脏密度无明显差异 ( t=-1.076,P>0.05)。临床研究:CT测量的不包括肝中静脉右半肝体积和实际移植肝体积的差异为10%,利用回归直线公式修正过的CT测量肝体积和实际移植肝体积差异为2.6%。 结论 CT测量肝体积与实际肝体积之间呈正相关,供肝切取和灌洗是造成两者之间差异的主要原因。64层螺旋CT评估肝脏体积有较好的准确性及可重复性。可利用回归直线公式纠正活体肝移植术前CT测量肝脏体积的偏差。
Other AbstractObjective To study the accuracy of CT liver volume measurement by using 64-slice spiral computed tomography(64-SCT), the relationship and the reason of difference between CT Liver volume and actual liver volume were analyzed. To precise evaluation the preoperative liver volume of living donor liver transplantation . Methods Experiment study:thirty rabbits were randomly assigned to experiment group or control group(15 for each); thirty rabbits livers were scanned by using 64-SCT at three enhancement phases. The whole rabbit liver volume were measured with two kinds of axial slices (1mm and 3mm) and two phases ( the hepatic venous phase and the portal vein phase) on a image post-processing work station respectively. Each actual liver vo lume and their weight were measured by water displacement and scales immediately, experiment group were simulated donor liver perfusion of liver transplantation, control group liver vessel were ligatured prior to resection respectively. To analyze relationship between CT liver volume and actual liver volume and to abtain regression line equation. Clinical study: one donor liver was scanned by using 64-SCT at two enhancement phases. The whole liver volume and partial liver volume were measured with slice(3mm) at the portal vein phase on a image post-processing work station respectively; The resected of graft liver was weighed during the operation. The validity of the regression line equation was verified by the forthcoming clinical data. Results Experiment study: The CT liver volume of experiment group and control group with two slices and phases were significantly correlated with actual liver volume (all r<0.975, P<0.001), and could be expressed in the equation: the ALV (ml) of experment group =-9.619+ 0.925*CTLV –V1mm(cm3); =-11.533 +0.941* CTLV - V3mm (cm3); =-13.766+0.977*CTLV-P1mm(cm3); =-12.242+0.942* CTLV-P3mm (cm3); the ALV (ml) of control group =0.016+0.954*CTLV-V1mm(cm3); =1.553 + 0.910*CTLV-V3mm(cm3); =3.653 +0.901*CTLV-P1mm(cm3); =8.552 +0.988*CTLV-P3mm(cm3). The difference ratio of two groups between CT liver volume and actual liver volume was 20.2 ±0.5%, 6.29 ±0.43%. liver density was 1.000± 0.011g/ml, 1.003 ± 0.007 g/ml respectively. The difference of two groups between CT liver volume and actual liver volume had statistical significance(F= 420.380, P < 0.05) , There were no significantly difference between CT liver volume and actual liver volume at two slice and two phase(F=3.038, P>0.05; F...
URL查看原文
Language中文
Document Type学位论文
Identifierhttps://ir.lzu.edu.cn/handle/262010/223291
Collection学院待认领
Affiliation临床医学院
Recommended Citation
GB/T 7714
周星. 活体肝移植术前64层螺旋CT肝体积评估的实验和临床研究[D]. 兰州. 兰州大学,2009.
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