Ha Yeonjung, Shim Ju Hyun, Song Gi-Won, Kim Seon-Ok, Ha Tae-Yong, Jung Dong-Hwan, Kim Kang Mo, Lim Young-Suk, Lee Han Chu, Lee Sung-Gyu
¹Department of Gastroenterology Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine; and ²Department of Gastroenterology, CHA Bundang Medical Center, CHA University, Republic of Korea.
Exp Clin Transplant. 2017 Apr;15(2):196-202. doi: 10.6002/ect.2016.0065.
Our objective was to assess the accuracy of computed tomography volumetry in estimating liver volume in steatotic patients.
We divided 641 liver donors (mean age 27 years, 71% male) into 4 groups according to the extent of steatosis on predonation biopsy: with < 5% comprising group 1, 5% to 9% comprising group 2, 10% to 19% comprising group 3, and ≥ 20% comprising group 4. Graft mass estimation error (%) was calculated as follows: [(computed tomography-measured volume minus graft weight)/graft weight] × 100. We obtained estimation errors, intraclass correlation coefficients, and Pearson correlation coefficients across the groups.
Baseline alanine aminotransferase and gammaglutamyltranspeptidase values were signi ficantly correlated with extent of steatosis. Mean graft weight and computed tomography-measured volume were 725.9 g and 741.2 mL. Mean estimation errors were comparable (1.5% for group 1, 2.7% for group 2, 3.0% for group 3, and 3.9% for group 4; P = .77). In multivariate linear regression, estimation error was inversely correlated with high-density lipoprotein cholesterol (P = .008). Overall, there was an excellent agreement between measured volume and actual weight, with intraclass correlation coefficients over 0.85 and Pearson correlation coefficients over 0.70 in all groups (P < .001).
Preoperative computed tomography volumetry is an accurate tool for estimating volume regardless of the extent of steatosis.
我们的目的是评估计算机断层扫描体积测量法在估计脂肪变性患者肝脏体积方面的准确性。
我们根据捐赠前活检的脂肪变性程度将641名肝脏供体（平均年龄27岁，71%为男性）分为4组：脂肪变性程度<5%的为第1组，5%至9%的为第2组，10%至19%的为第3组，≥20%的为第4组。移植体质量估计误差（%）的计算方法如下：[（计算机断层扫描测量的体积减去移植体重量）/移植体重量]×100。我们获得了各组的估计误差、组内相关系数和Pearson相关系数。
基线丙氨酸氨基转移酶和γ-谷氨酰转肽酶值与脂肪变性程度显著相关。平均移植体重量和计算机断层扫描测量的体积分别为725.9 g和741.2 mL。平均估计误差相当（第1组为1.5%，第2组为2.7%，第3组为3.0%，第4组为3.9%；P = 0.77）。在多变量线性回归中，估计误差与高密度脂蛋白胆固醇呈负相关（P = 0.008）。总体而言，测量体积与实际重量之间具有良好的一致性，所有组的组内相关系数均超过0.85，Pearson相关系数均超过0.70（P < 0.001）。
术前计算机断层扫描体积测量法是一种准确的工具，无论脂肪变性程度如何，均可用于估计肝脏体积。
