CT体积测量评价不同病因肝硬化肝叶体积的差异

Evaluation on differences in hepatic lobe volume of liver cirrhosis with different causes by CT volume measurement

摘要:

目的：采用320排CT分别测量尾状叶体积（caudate lobe volume，CV）、左内叶体积（left medial liver segment volume，LMV）、左外叶体积（left lateral liver segment volume，LLV）、右前叶体积（right anterior liver segment volume，RAV）、右后叶体积（right posterior liver segment volume，RPV），左半肝体积（left liver lobe volume，LV）、右半肝体积（right liver lobe volume，RV）及全肝体积（total liver volume，TLV）。探讨由不同病因引起的肝硬化肝叶体积变化规律及分布是否不同。方法：收集经临床资料、CT检查确诊的4种病因（酒精性、乙肝、隐源性、胆汁淤积性）肝硬化病人共107人，采用仪器自身携带的软件，分别测量肝脏各叶的体积及所占全肝的百分比。结果：CV、LMV、RAV、RPV、RV、LV、TLV酒精性肝硬化组大于乙肝、隐源性及胆汁淤积性肝硬化组（P<0.008 33），CV胆汁淤积性肝硬化组大于乙肝肝硬化组（P=0.000）。CV/ TLV乙肝肝硬化组小于酒精性、胆汁淤积性肝硬化组（P=0.002，P=0.000）。RPV/ TLV胆汁淤积性肝硬化组小于酒精性、乙肝肝硬化组（P=0.005，P=0.008），RPV/RV胆汁淤积性肝硬化组小于酒精性、乙肝、隐源性肝硬化组（P=0.001，P=0.005，P=0.006）。结论：通过320排 CT对肝各叶体积的定量分析，发现不同病因引起的肝硬化肝各叶体积变化及分布不尽相同，肝硬化的体积与发病病因有关。

Abstract:

Objective：To investigate the differences of hepatic lobe volume and distribution in patients with different causes of liver cirrhosis（LC） by measuring caudate lobe volume（CV），left medial liver lobe volume（LMV），left lateral liver lobe volume（LLV），right anterior liver lobe volume（RAV），right posterior liver lobe volume（RPV），left liver lobe volume（LV），right liver lobe volume（RV），and total liver volume（TLV） using 320 slice CT. Methods：A volume CT scan was performed in 107 patients with LC of 4 different causes（alcohol，hepatitis B virus（HBV），cryptogenic and cholestatic cirrhosis）. Volume of the each liver lobe was measured respec－tively，and the total liver volume and the percentage of each lobe in the liver were also calculated. Results：CV，LMV，RAV，RPV，RV，LV and TLV were larger in alcoholic cirrhosis group than in cryptogenic and cholestatic cirrhosis groups（P<0.008 33）. CV was larger in cholestatic cirrhosis group than in HBV cirrhosis group（P=0.000）. CV/TLV was smaller in HBV cirrhosis group than in alcoholic cirrhosis group and cholestatic cirrhosis group（P=0.002，P=0.000）. RPV/TLV was smaller in cholestatic cirrhosis group than in HBV cirrhosis group and alcoholic cirrhosis group（P=0.005，P=0.008）. RPV/RV was smaller in cholestatic cirrhosis group than in HBV cir－rhosis group，alcoholic cirrhosis group and cryptogenic cirrhosis group（P=0.001，P=0.005，P=0.006）. Conclusions：There are differences in the changes of the hepatic lobe volume and distribution in patients with different causes of LC by the quantitative analysis of liver lobes volume using 320 slice CT.Changes of the hepatic volume are correlated with the causes of liver cirrhosis.