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Use of Computed Tomography Volumetry to Assess Liver Weight in Patients With Cirrhosis During Evaluation Before Living-Donor Liver Transplant

机译:计算断层摄影体积的使用评估肝硬化患者的肝脏重量在患者肝脏移植前评估

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Objectives: Computed tomography liver volumetry has been widely used to detect total and segmental liver volume in living-donor liver transplantation. However, use of this technique to evaluate the cirrhotic liver remains unclear. In this study, we evaluated the accuracy of freehand computed tomography volumetry to assess total liver volume by comparing weights of total hepatectomy specimens in patients with cirrhosis. For our analyses, we considered the density of a cirrhotic liver to be 1.1 kg/L. Materials and Methods: Liver volume was measured using a freehand computed tomography technique in 52 patients with cirrhosis from different causes and who had no solid lesions before transplant. Measurements were made with a 16-slice multidetector computed tomography scanner (Siemens Somatom Sensation 16, Erlangen, Germany). For volumetric measurements, 10-mm-thick slices with 10-mm reconstruction intervals were preferred. Total hepatectomy weights of explant livers and computed tomography volumetry data were compared. Results: We excluded 3 cirrhotic patients with Budd-Chiari syndrome due to wide variations in scatterplot results. In the 49 patients included in the final analyses, average estimated liver volume by computed tomo-graphy was 721 ?± 398 mL and actual cirrhotic liver weight was 727.8 ?± 415 g. No significant differences were shown between these measurements. A simple reg-ression analysis used to analyze correlations between estimated liver volume by computed tomography and real cirrhotic liver weight showed correlation of 0.957 ( P .001). When computed tomography liver volumetry as the independent variable and cirrhotic liver weight as dependent variable were considered, regression analyses showed R 2 = 0.915. Conclusions: Freehand computed tomography liver volumetry can be confidently used to evaluate liver volume in cirrhotic liver patients similar to use of this technique to estimate actual weights in normal livers. This technique can also be valuable during pretransplant and liver resection evaluations to ensure a more successful outcome.
机译:目的:计算机断层扫描肝体积已被广泛用于检测在生活供体肝移植中的总和节段性肝脏体积。然而,使用这种技术来评估肝硬化肝脏仍然不清楚。在这项研究中,我们通过比较肝硬化患者总肝切除术标本的重量来评估手绘计算机断层摄影体积的准确性,以评估总肝切除术标本的重量。对于我们的分析,我们认为肝硬化肝的密度为1.1 kg / l。材料和方法:使用在不同原因的肝硬化患者中使用手法计算断层扫描技术测量肝脏体积,并且在移植前没有固体病变。用16切片多搬运商计算的断层扫描仪(西门子Somatom Sensation 16,Erlangen,德国)进行了测量。对于体积测量,优选具有10mm重建间隔的10mm厚的切片。比较了消除肛门肝脏的总肝切除术权重和计算断层扫描体积数据。结果:由于散点图结果广泛变化,我们排除了3例肝硬化患者患者。在最终分析中的49名患者中,计算的Tomo-Graphy的平均估计肝体积为721?±398 ml,实际肝脏肝脏重量为727.8?±415克。这些测量之间没有显示显着差异。用于分析计算断层摄影和实际肝硬化肝脏重量的估计肝体之间的相关性的简单侦录分析表明0.957(P <.001)的相关性。当考虑到依赖变量的独立变量和肝硬化肝脏重量计算的断层摄影肝体积时,回归分析显示R 2 = 0.915。结论:手法式计算机断层扫描肝体积可以自信地用于评估肝硬化肝脏患者的肝体,类似于这种技术的使用来估算正常肝脏中的实际权重。这种技术在预体和肝切除评估中也可以是有价值的,以确保更成功的结果。

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