Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Clin Mol Hepatol. 2018 Mar;24(1):54-60. doi: 10.3350/cmh.2017.0023. Epub 2017 Aug 1.
BACKGROUND/AIMS: Computed tomography (CT) hepatic volumetry is currently accepted as the most reliable method for preoperative estimation of graft weight in living donor liver transplantation (LDLT). However, several factors can cause inaccuracies in CT volumetry compared to real graft weight. The purpose of this study was to determine the frequency and degree of resection plane-dependent error in CT volumetry of the right hepatic lobe in LDLT.
Forty-six living liver donors underwent CT before donor surgery and on postoperative day 7. Prospective CT volumetry (V) was measured via the assumptive hepatectomy plane. Retrospective liver volume (V) was measured using the actual plane by comparing preoperative and postoperative CT. Compared with intraoperatively measured weight (W), errors in percentage (%) V and V were evaluated. Plane-dependent error in V was defined as the absolute difference between V and V. % plane-dependent error was defined as follows: |V-V|/W∙100.
Mean V, V, and W were 761.9 mL, 755.0 mL, and 696.9 g. Mean and % errors in V were 73.3 mL and 10.7%. Mean error and % error in V were 64.4 mL and 9.3%. Mean plane-dependent error in V was 32.4 mL. Mean % plane-dependent error was 4.7%. Plane-dependent error in V exceeded 10% of W in approximately 10% of the subjects in our study.
There was approximately 5% plane-dependent error in liver V on CT volumetry. Plane-dependent error in V exceeded 10% of W in approximately 10% of LDLT donors in our study. This error should be considered, especially when CT volumetry is performed by a less experienced operator who is not well acquainted with the donor hepatectomy plane.
背景/目的：计算机断层扫描（CT）肝体积测量目前被认为是活体肝移植（LDLT）术前估计供体移植物重量的最可靠方法。然而，与实际移植物重量相比，CT 体积测量会受到几个因素的影响而产生误差。本研究的目的是确定 LDLT 中右肝叶 CT 体积测量时，肝切除平面依赖性误差的频率和程度。
46 名活体肝供者在供体手术前和术后第 7 天行 CT 检查。通过假设的肝切除术平面进行前瞻性 CT 体积测量（V）。通过比较术前和术后 CT 来测量实际肝平面的实际肝体积（V）。评估体积百分比（%）V 和 V 的测量误差。将 V 的平面依赖性误差定义为 V 与 V 之间的绝对差值。%平面依赖性误差定义为：|V-V|/W×100。
平均 V、V 和 W 分别为 761.9 mL、755.0 mL 和 696.9 g。V 的平均和%误差分别为 73.3 mL 和 10.7%。V 的平均误差和%误差分别为 64.4 mL 和 9.3%。V 的平均平面依赖性误差为 32.4 mL。%平面依赖性误差的平均值为 4.7%。在本研究中，约 10%的受检者 V 的平面依赖性误差超过 10%W。
CT 体积测量中肝 V 存在约 5%的平面依赖性误差。在本研究的 LDLT 供者中，约 10%的供者 V 的平面依赖性误差超过 10%W。当经验不足的操作者对供体肝切除术平面不熟悉时，应考虑这种误差。
