活体肝移植中IQQA法与手工描记法对供肝体积评估的比较研究

摘要

目的 评估IQQA肝脏影像解读分析系统在活体肝移植术前评估供者肝脏的安全性和准确性,并探讨其临床意义.方法 2007年6月至2010年7月间共有123例活体供者接受供肝手术,供肝均为右半肝,其中56例含肝中静脉.首先采用16层螺旋CT对供者肝脏进行扫描,然后分别采用MSCT手工描记法和IQQA法测量肝脏体积,分别记录两种方法测量供肝体积的耗时,并以术中实际测量的供肝重量作为参照标准,采用Pearson相关系数行IQQA法和MSCT手工描记法测量值与实测值间的相关分析,并进行线性回归分析.结果 IQQA法和MSCT手工描记法测量供肝的体积分别为(856.76±162.18)cm3和(870.64±172.54)cm3,二者比较,差异无统计学意义(P＞0.05)；测量耗时分别为(16.9±1.4)min和(39.3±2.1)min,二者比较,差异有统计学意义(P＜0.05)；术中实际测量的供肝体积为(632.59±131.73)cm3,两种术前评估方法均与实测肝重呈显著正相关性(r值分别为0.896和0.921,P＜0.01)；回归方程:术中实测重量=- 150.303+1.025× IQQA法测得值,术中实测重量=-94.397+ 0.955× MSCT手工描记法测得值.结论 与临床常用的MSCT手工描记法相比较,IQQA肝脏影像解读分析系统评估活体肝移植供肝体积具有相同的安全性、准确性和稳定性,著且测量耗时明显缩短；IQQA系统提供的三维血管重建和模拟肝脏切割功能能够更好的促进临床医生对供者肝脏解剖结构的了解.%Objective To investigate the safty and accuracy ot estimating the living donor's graft volume with IQQA liver imaging evaluation system.Methods Between June 2007 and July 2010,123living liver donors were enrolled to undergo 16-slice CT scanning,then graft volume was estimated by both IQQA and manu-traced multi-slice spiral computed tomography (MSCT) approach.The graft volume and time consuming between IQQA and manu-traced MSCT were compared. Pearson Correlation test was uesd to verify the correlation between the estimated graft volume estimated each method and actual graft weight detected in operation.Linear correlation analysis was done.Results The mean graft volume by IQQA and manu-traced MSCT was (856.76 ± 162.18) and (870.64 ±172.54) cm3 respectively preoperation.Paired t-test showed there was no statistically significant difference between IQQA and MSCT methods (P＞0.05).It took mean ( 16.9 ± 1.4) min to calculatethe graft volume by IQQA and (39.3 ± 2.1 ) min by manu-traced MSCT,respectively (P＜0.05).The real graft volume was (632.59 ± 13 1.73) cm3.Pearson correlation test showed the graft volume calculated by either IQQA or MSCT method had a significantly positive correlation with the real graft weight (MSCT r =0.921,IQQA r =0.896,P＜0.01 ).Graft weight could be expressed in the equation:Actual graft weight =- 150.303 + 1.025 × IQQA value or =- 94.397 + 0.955 × MSCT value.Conclusion IQQA system has same accuracy with MSCT method in predicting the graft volume but consuming less time.IQQA system promotes the recognition of clinician on liver three dimensional anatomic structure.