Lemke A J, Hosten N, Neumann K, Müller B, Neuhaus P, Felix R, Langer R
Strahlenklinik und Poliklinik, Virchow-Klinikum, Medizinische Fakultät, Humboldt-Universität zu Berlin.
Rofo. 1997 Jan;166(1):18-23. doi: 10.1055/s-2007-1015371.
Purpose of the study was to assess the predictive accuracy of preoperative CT volumetry for water displacement volume after liver transplantation.
In a retrospective study the liver volume of 52 patients who underwent an orthotopic liver transplantation, was calculated preoperatively based on incremental and spiral computed tomography (CT). The calculated values were compared with the liver volume measured by water displacement and weight of the extirpated liver.
Marked differences of 19-21.5% were seen between calculated CT volume and water displacement volume for the entire group, and of 12.4-16.9% for livers with a plausible physical liver density (0.9 and 1.1 g/cm3). In this group, 68-86% of the livers were in the acceptable tolerance range for a predictive accuracy (+10% to -20%). Other error sources, such as the breathing shift of the abdominal organs and interobserver variability (1.5-2.7%), were of minor importance for volume calculation.
In conclusion, both incremental CT and spiral CT are reliable methods for the preoperative estimation of the liver volume, whereas best accordance with the corrected water displacement volume was obtained using the individual segmentation thresholds.
本研究的目的是评估术前CT容积测量法对肝移植后水置换体积的预测准确性。
在一项回顾性研究中,对52例行原位肝移植患者的肝脏体积进行术前计算,计算方法基于增量CT和螺旋CT。将计算值与通过水置换法测量的肝脏体积以及切除肝脏的重量进行比较。
整个组中,计算得到的CT体积与水置换体积之间存在19%至21.5%的显著差异,对于物理肝脏密度合理(0.9和1.1 g/cm³)的肝脏,差异为12.4%至16.9%。在该组中,68%至86%的肝脏预测准确性(+10%至-20%)处于可接受的耐受范围内。其他误差来源,如腹部器官的呼吸移位和观察者间差异(1.5%至2.7%),对体积计算的影响较小。
总之,增量CT和螺旋CT都是术前估计肝脏体积的可靠方法,而使用个体分割阈值可获得与校正后的水置换体积最佳的一致性。