多层螺旋CT体积测量在肝硬化患者肝脏储备功能评估中的应用

摘要/Abstract

摘要： 目的探讨肝硬化患者采用多层螺旋CT体积测量肝脏储备功能的应用价值。方法选择2020年6月—2023年6月在宣城市人民医院进行肝脏储备功能检查的42例健康体检者为正常组,选择同期收治的42例肝硬化患者为肝硬化组,所有患者均行多层螺旋CT体积测量,分析肝硬化患者肝脏储备功能与多层螺旋CT体积测量值的相关性。结果 42例患者肝功能Child-Pugh分级A级患者17例,占40.48%,B级患者18例,占42.86%,C级患者7例,占16.67%;肝硬化组全肝体积、右叶体积、左内叶体积分别为(1040.31±224.51)、(521.37±105.52)、(150.85±45.18)cm³,低于正常组[分别为(1408.62±158.57)、(932.27±165.64)、(224.19±43.67)cm³],尾状叶体积为(39.60±9.69)cm³,高于正常组[(20.96±12.18)cm³, P<0.05);A级患者全肝体积、右叶体积、左内叶体积分别为(1233.85±192.65)、(624.67±76.11)、(179.51±47.96)cm³,高于B级和C级患者[B级分别为(1028.52±164.61)、(517.53±66.17)、(154.96±33.77)cm³,C级分别为(899.33±141.55)、(472.21±57.21)、(129.91±31.12)cm³],尾状叶体积为(30.30±6.15)cm³, 低于B级和C级患者[分别为(39.47±6.02)和(46.11±6.12)cm³,P<0.05];经Kendall's tau-b相关性分析,多层螺旋CT全肝体积、右叶体积、左内叶体积与肝硬化患者肝功能Child-Pugh分级呈正相关(r=0.325、0.329、0.256,P<0.05),多层螺旋CT尾状叶体积测量值与肝硬化患者肝功能Child-Pugh分级呈负相关(r=-0.396,P<0.05);绘制受试者工作曲线(ROC)结果显示,多层螺旋CT全肝体积、右叶体积、左内叶体积、尾状叶体积以及联合测量值评估肝硬化患者肝功能Child-Pugh分级的AUC均＞0.7,具有一定评估价值。结论多层螺旋CT测量全肝体积、右叶体积、左内叶体积、尾状叶体积值可用于评估肝硬化患者肝脏储备功能,具有一定的评估价值。

关键词: 多层螺旋CT, 体积测量, 肝硬化, 肝脏储备功能

Abstract: Objective To explore the application value of multi-slice spiral CT volu-me measurement of liver reserve function in patients with liver cirrhosis. Methods 42 healthy individuals who underwent liver reserve function examinations in Xuancheng City People's Hospital from June 2020 to June 2023 were selected as the normal group, while 42 patients with cirrhosis admitted during the same period were selected as the cirrhosis group. All patients underwent the multi-slice spiral CT volume measurement to analyze the corr-elation between liver reserve function and multi-slice spiral CT volume measurement value in patients with liver cirrhosis. Results Among 42 patients, there were 17 patients with Child Pugh grade A (40.48%), 18 patients with grade B (42.86%), and 7 patients with grade C (16.67%). The total liver volume [(1040.31±224.51)cm³], right lobe volume [(521.37±105.52)cm³], and left inner lobe volume [(150.85±45.18)cm³] in the cirrhosis group were lower than those in the normal group (total liver volume, 1408.62±158.57); (right lobe volume, 932.27±165.64); (left inner lobe volume, 224.19±43.67). The caudate lobe volume [(39.60±9.69)cm³] was higher than that in the normal group [(20.96±12.18)cm³,P<0.05]. The total liver volume [(1233.85±192.65)cm³], right lobe volume [(624.67±76.11)cm³] and left medial lobe volume [(179.51±47.96)cm³] in patients with grade A were higher than those in patients with grade B and C ( (total liver volume, 1028.52±164.61 and 899.33±141.55); (right lobe volume, 517.53±66.17 and 472.21±57.21); (left medial lobe volume, 154.96±33.77 and 129.91±31.12) ). The volume of caudate lobe [(30.30±6.15)cm³] was lower than that of patients with grade B and C [(39.47±6.02 and 46.11±6.12)cm³,P<0.05]. According to Kendall's tau-b correlation analysis, the total liver volume, right lobe volume, and left inner lobe volume of multi-slice spiral CT were positively correlated with the Child Pugh grade of patients with cirrhosis (r=0.325, 0.329, 0.256, P<0.05), while the measured volume of the caudate lobe by multi-slice spiral CT was negatively correlated with the Child Pugh grade in patients with cirrhosis (r=-0.396, P<0.05). The results of drawing receiver operating curve (ROC) curves showed that the area under the curve (AUC) of the total liver volume, right lobe volume, left inner lobe volume, caudate lobe volume, and combined measurement values for evaluating the Child-Pugh grading of liver function in patients with liver cirrhosis were all greater than 0.7, which had a certain evaluation value. Conclusion Multi-slice spiral CT measurement of total liver volume, right lobe volume, left inner lobe volume, and caudate lobe volume can be used to evaluate liver reserve function in patients with liver cirrhosis, and has certain evaluation value.

Key words: Multi-slice spiral CT, Volume measurement, Liver cirrhosis, Liver reserve function

修智, 邹智超, 张颖琳, 安鑫, 向以四. 多层螺旋CT体积测量在肝硬化患者肝脏储备功能评估中的应用[J]. 肝脏, 2024, 29(10): 1235-1238.

XIU Zhi, ZOU Zhi-chao, ZHANG Ying-lin, AN xin, XIANG Yi-si. Application of multi-slice spiral CT volume measurement in evaluating liver reserve function in patients with liver cirrhosis[J]. Chinese Hepatolgy, 2024, 29(10): 1235-1238.

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