CT-based liver volumetry in a porcine model: Impact on clinical volumetry prior to living donated liver transplantation
CT-based liver volumetry in a porcine model: Impact on clinical volumetry prior to living donated liver transplantation
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DOI：
10.1055/s-2004-817636
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发表时间：
2004-02-01
影响因子：
1.8
通讯作者：
Galanski, M
中科院分区：
文献类型：
--
作者：
Frericks, BBJ;Kiene, T;Galanski, M
目的：术前准确测定肝脏体积是肝胆外科手术的重要内容，尤其是活体肝移植（LDLT）。在目前的文献中，已经描述了术前计算的和术中测量的肝脏体积之间的强相关性。这种准确性似乎值得怀疑，主要是由于原位肝脏灌注状态与移植后肝脏灌注状态的差异。本研究的目的是评估灌注状态对肝脏体积的影响以及LDLT术前肝脏体积测量的有效性。方法：对20例猪肝进行了实验研究。对肝脏进行称重，并在液体输注前后通过水置换确定其体积，以达到肝静脉中的生理压力。根据CT数据计算不同灌注状态下的肝脏体积。将计算值与通过水置换测量的体积和肝脏重量进行比较。结果如下：在相同灌注状态下计算的CT体积和水位移的评估显示出紧密的相关性，平均差异为4 +/-5%。然而，液体输注前后的肝脏显示体积差异为33 +/-8%（350 +/- 150 ml）。结论：CT容量法获得了水置换研究所证实的高度准确的数据。然而，灌注状态对肝脏体积有重大影响，这在临床使用中必须考虑。
Purpose: Exact preoperative determination of the liver volume is of great importance prior to hepatobiliary surgery, especially in living donated liver transplantation (LDLT). In the current literature, a strong correlation between preoperatively calculated and intra operatively measured liver volumes has been described. Such accuracy seems questionable, primarily due to a difference in the perfusion state of the liver in situ versus after explantation. Purpose of the study was to asses the influence of the perfusion state on liver volume and the validity of the preoperative liver volumetry prior to LDLT. Methods: In an experimental study 20 porcine livers were examined. The livers were weighted and their volumes were determined by water displacement prior and after fluid infusion to achieve a pressure physiologically found in the liver veins. The liver volumes in the different perfusion states were calculated based on CT-data. The calculated values were compared with the volume measured by water displacement and the weight of the livers. Results: Assessment of calculated CT volumes and water displacements at identical perfusion states showed a tight correlation and differed on average by 4 +/- 5%. However, livers before and after fluid infusion showed a 33 +/- 8 % (350 +/- 150 ml) difference in volume. Conclusion: CT-volumetry acquires highly accurate data as confirmed by water displacement studies. However, the perfusion state has major impact on liver volume, which has to be accounted for in clinical use.