Ishifuro M, Horiguchi J, Ohshita A, Itamoto T, Ohdan H, Ito K
Department of Clinical Radiology, Hiroshima University Hospital, Hiroshima, Japan.
Transplant Proc. 2009 Nov;41(9):3772-4. doi: 10.1016/j.transproceed.2009.06.202.
The purpose of the study was to examine changes in splenic volume among recipients during the course of adult-to-adult living donor liver transplantation (LDLT) using multislice computed tomography (CT) scanning with a semiautomatic volumetry software.
Forty-eight patients, including 33 males and a mean overall age of 54 +/- 8 years), underwent liver transplantation for the primary disease of liver cirrhosis with or without hepatocellular carcinoma (n = 31/17, respectively). The mean MELD score was 14 +/- 6. The liver graft mass compared with recipient weight was 74% +/- 28%. Splenic artery embolization was not performed. Dynamic CT scans splenic volume, and platelet counts (10(3)/cm(3)) were obtained pre, < or =50 day and > or =90 days postoperatively.
The total time to generate volumetry and image postprocessing per examination was <10 minutes. One-factor analysis of variance (ANOVA) revealed that the average splenic volume tended to be reduced from pre- to post-LDLT, although not significantly: pre-LDLT, 469 +/- 270 mL; < or =day 50, 369 +/- 212 mL; and > or =day 90, 378 +/- 210 mL (P = .066). One-factor ANOVA revealed that the average platelet count was significantly different in the 3 periods: pre-LDLT, 69 +/- 32 x 10(3)/cm(3); < or =day 50, 181 +/- 253 x 10(3)/cm(3); and > or =day 90, 126 +/- 64 x 10(3)/cm(3) (P < .01). The post hoc Scheffé test revealed the statistical significance of the platelet counts between pre-LDLT and < or =day 50 (P < .01).
Splenic volumetry with multislice CT and semiautomatic software, which is simple and not time consuming, was able to evaluate remission from hypersplenism during the course of LDLT.
本研究旨在利用多层计算机断层扫描（CT）及半自动容积测量软件，检测成人对成人活体肝移植（LDLT）受者脾脏体积的变化情况。
48例患者（包括33例男性，平均年龄54±8岁）因肝硬化合并或不合并肝细胞癌（分别为n = 31/17）接受肝移植。平均终末期肝病模型（MELD）评分14±6。移植肝重量与受者体重之比为74%±28%。未进行脾动脉栓塞。于术前、术后≤50天及≥90天进行动态CT扫描测量脾脏体积并检测血小板计数（10³/立方厘米）。
每次检查生成容积测量和图像后处理的总时间<10分钟。单因素方差分析显示，LDLT术后脾脏平均体积虽未显著降低，但有从术前到术后减小的趋势：术前为469±270毫升；≤50天时为369±212毫升；≥90天时为378±210毫升（P = 0.066）。单因素方差分析显示，3个时期的平均血小板计数有显著差异：术前为69±32×10³/立方厘米；≤50天时为181±253×10³/立方厘米；≥90天时为126±64×10³/立方厘米（P < 0.01）。事后Scheffé检验显示术前与≤50天时血小板计数有统计学意义（P < 0.01）。
使用多层CT及半自动软件进行脾脏容积测量，操作简单且耗时短，能够评估LDLT过程中脾功能亢进的缓解情况。
