Assessment of hepatic functional reserve by cirrhosis grading and liver volume measurement using CT

作     者：Rong Tu Li-Ping Xia An-Le Yu Ling Wu 

作者机构：Department of Radiology of Affiliated Hospital of Hainan Medical College Cancer Research Center of Hainan Medical College Haikou 571101 Hainan Province China Department of Surgery of Affiliated Hospital of Hainan Medical College Haikou 571101 Hainan Province China Department of Statistics of Hainan Medical College Haikou 571101 Hainan Province China 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2007年第13卷第29期

页      面：3956-3961页

核心收录：

学科分类：0831[工学-生物医学工程（可授工学、理学、医学学位）] 100207[医学-影像医学与核医学] 1006[医学-中西医结合] 1002[医学-临床医学] 1001[医学-基础医学(可授医学、理学学位)] 08[工学] 1010[医学-医学技术（可授医学、理学学位）] 100214[医学-肿瘤学] 100106[医学-放射医学] 100602[医学-中西医结合临床] 10[医学] 

基　　金：Supported by the Natural Science Foundation of Hainan Province  No. 30527 

主　　题：Hepatic functional reserve Liver cirrhosis Computed tomography Hepatocellular carcinoma 

摘      要：AIM： To explore a method for quantitative assessment of hepatic functional reserve by combining computed tomography （CT） volumetry with CT grading of liver cirrhosis before liver resection in patients with hepatocellular carcinoma. METHODS： CT images of 55 patients undergoing liver resection were studied prospectively. The degree of liver cirrhosis was referred as ＂CT grade＂ and the percentage of remnant liver volume （PRLV） [PRLV = predicted RLV/predicted total liver volume （PTLV） × 100%; PTLV （mL） = 121.75 ＋ 16.49 × body mass （kg）] were calculated by adding slice by slice of CT liver images. The postoperative RLV, pathologic stages of liver fibrosis in non-tumor area and survival time in these cases were analyzed. RESULTS： There was a significant difference in survival time between the group with PRLV ≤ 50% and the group with PRLV 〉 50% （X^2= 4.988, P = 0.026）, and between the group with CT grade 0/1 and the group with CT grade 2/3 （X^2= 5.429, P = 0.026）. With combination of the both parameters, an oblique line was identified according to the distribution of 32 survivors versus 23 deceased subjects. The mortality rate above the line was 7.1% （1/14）, and that below the line was 53.7% （22/41）, indicating a significant difference between the two rates （X^2 = 9.281, P = 0.002, P 〈 0.05）. CONCLUSION： PRLV and CT grades are significantly correlated with hepatic functional reserve. The predicted line using these two parameters is useful in candidates undergoing liver resection for judging hepatic functional reserve.