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1、256層MSCT肝臟體積測量在肝腫瘤行精準(zhǔn)肝切除中的初步應(yīng)用王均干1李成萬3殷允娟1（通訊作者）侯海燕1姜建威1金成2（1無錫市第三人民醫(yī)院影像屮心江蘇無錫214041）（2無錫市第三人民醫(yī)院肝膽外科江蘇無錫214041）（3無錫市第三人民醫(yī)院科教科江蘇無錫214041）【摘要】目的：探討256層CT肝臟體積測量對(duì)肝腫瘤行精準(zhǔn)肝切除的指導(dǎo)價(jià)值。方法：收集臨床擬診肝腫瘤患者16例，術(shù)前均行256層MSCT常規(guī)平掃+雙期增強(qiáng)掃描，將門脈期薄層圖像傳至后處理工作站，應(yīng)用肝臟體積測量軟件（Liver）,分析肝腫瘤的位置人小與周圍血管的空間位置關(guān)系，并生成全肝體積，肝腫
2、瘤體積。經(jīng)影像科醫(yī)師與外科醫(yī)師共同討論制定可能的手術(shù)方案，分析預(yù)切除肝臟體積，將手術(shù)標(biāo)本采用水測法，得出切除標(biāo)本的總體積。將預(yù)切除肝臟體積與手術(shù)標(biāo)本體積間進(jìn)行線性相關(guān)分析。結(jié)果：16例患者屮，原發(fā)性肝癌13例，轉(zhuǎn)移性肝癌1例，肝臟血管瘤2例，預(yù)切除肝臟體積介于170.53±175.91ml,手術(shù)標(biāo)本體積介于143.67&plUSmn;120.15mlM者間差異不具有統(tǒng)計(jì)學(xué)意義（P=0.216,>0.05）o術(shù)前預(yù)切除體積百分比與術(shù)后標(biāo)本相比，差異無統(tǒng)計(jì)學(xué)意義（χ2=210,P>；0.05）o依據(jù)術(shù)前制定的手術(shù)切除方案，所有腫瘤均
3、得以完整切除。預(yù)切除肝臟體積與手術(shù)標(biāo)本體積間明顯相關(guān)（相關(guān)系數(shù)為0.921）。結(jié)論：256層肝臟體積測量可以為臨床施行精準(zhǔn)肝切除提供個(gè)體化指導(dǎo)的影像學(xué)依據(jù)?！娟P(guān)鍵詞】肝臟；體積測量；腫瘤；螺旋CT,計(jì)算機(jī)斷層成像；精準(zhǔn)肝切除【屮圖分類號(hào)】R73【文獻(xiàn)標(biāo)識(shí)碼】A【文章編號(hào)】1007-8231（2015）10-0056-03Preliminaryapplicationof256sliceMSCThepaticvolumemeasurementinpreciseliverresectionofhepatictumorsYinYunjuan,JinCheng2,Hou
4、Haiyanl,JiangJianweil.llmagingcenteroftheThirdaffiliationHospital,NantongUniversity,2DepartmentofHepatobiliarySurgery,thethirdaffiliationhospital,Nantonguniversity,WuxiJiangsuprovince,214O41.China[Abstract]ObjectiveToexploretheguidingvalueof256sliceMSCThepaticvolumemeasurementofhepa
5、tictumorforpreciseliverresection.Methods16patientsclinicaldiagnosedashepatictumorsunderwenttheplainanddouble-phasecontrast-enhancedscanson256sliceMSCT,thethinsliceimagesoftheportalphaseweretransferredintothesoftwareforhepaticvolumemeasurement,thelocationandsizeoftumorsandthespacerel
6、ationshipwithsurroundingvesselswereallanalyzed.Thewholelivervolumeandthetumorvolumeweremeasured,underthediscussionoftheradiologistandthehepatobiliarysurgeon,thepossiblesurgeryplansweremade,andthepredictiveresectionvolumeweremeasuredandstatisticallyanalyzedwiththatofoperativespecimen
7、accordingtowatermeasurementmethod.ResultsAmongthe16casesofhepatictumors,13caseswereprimaryhepaticcarcinomas,onewasmetastaticcarcinoma,andtheremainingtwowerehamangiomas.thevolumeofthepredictiveresectionandtheoperativespecimenrangedbetween170.53±175.91mland143.67±120.15m
8、lrespectivelywithno
