Assessment of liver regeneration after associating liver partition and portal vein ligation for staged hepatectomy: a comparative study with portal vein ligation
Assessment of liver regeneration after associating liver partition and portal vein ligation for staged hepatectomy: a comparative study with portal vein ligation
复制标题
分期肝切除术中肝分区与门静脉结扎联合后肝再生的评估：与门静脉结扎的比较研究
DOI：
10.1016/j.hpb.2017.09.004
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发表时间：
2018-04-01
期刊：
影响因子：
2.9
通讯作者：
Zeng, Meng-su
中科院分区：
文献类型：
--
作者：
Sheng, Ruo-fan;Yang, Li;Zeng, Meng-su
背景：探讨弥散峰度成像(DKI)和弥散加权成像(DWI)对分期肝切除联合肝分割门静脉结扎(ALPPS)和门静脉结扎(PVL)后肝再生的诊断价值。分别于术前和术后7d行DKI和DWI检查。计算并比较校正后的表观弥散系数(D)、峰度(K)和表观扩散系数(ADC)，评价其放射病理相关性。结果：ALPPS术后右中叶体积明显增大。ALPPS组和PVL组细胞直径明显增大(P=0.0003)。ALPPS后Ki-67和肝细胞生长因子的增殖指数升高(P=0.0024/0.0433)。D、K、ADC值组间差异有统计学意义(P=0.021/0.0015/0.0008)。D与肝细胞大小呈负相关(r=-0.523)，ADC值与K无相关性(P=0.159/0.111)。增殖指数与ADC值呈中度负相关(r=-0.484/-0.537)，与D、K值无相关性(P=0.100~0.877)。DKI，尤其是DMAP对评价ALPPS后肝再生的微观结构有一定的参考价值，但单用DKI模型可能不如标准的DWI单指数模型。
Background: To investigate the diagnostic value of diffusion kurtosis imaging (DKI) and diffusion-weighted imaging (DWI) in assessing liver regeneration after associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) compared with portal vein ligation (PVL).Methods: Thirty rats were divided into the ALPPS, PVL, and control groups. DKI and DWI were performed before and 7 days after surgery. Corrected apparent diffusion (D), kurtosis (K) and apparent diffusion coefficient (ADC) were calculated and compared, radiologic-pathologic correlations were evaluated.Results: The volume of the right median lobe increased significantly after ALPPS. There were larger cellular diameters after ALPPS and PVL (P = 0.0003). The proliferative indexes of Ki-67 and hepatocyte growth factor were higher after ALPPS (P = 0.0024/0.0433). D, K and ADC values differed between the groups (P = 0.021/0.0015/0.0008). A significant correlation existed between D and the hepatocyte size (r = -0.523), no correlations existed in ADC and K (P = 0.159/0.111). The proliferative indexes showed moderate negative correlations with ADC (r = -0.484/-0.537) and no correlations with D and K (P = 0.100-0.877).Discussion: Liver regeneration after ALPPS was effective and superior to PVL. DKI, especially the D map, may provide added value in evaluating the microstructure of liver regeneration after ALPPS, but this model alone may perform no better than the standard monoexponential model of DWI.