The Clinical Research Of Total And Segmental Liver Volume Measurement Using MSCT

【Objective】Liver volume has many practical clinical significations as the quantitative date of liver size and reserve function.Liver volume measurement has become a significant index for diagnosis of disease,operation plan designing and prognosis assessment.The satisfactory accuracy of liver volume has been obtained by CT.But the living donor liver transplantation not only requires total liver volume but also segmental liver volume measurement.So the aim of our experiment is to study the accuracy of total and segmental liver volume measurement using MSCT and the influencing factors of measurement.【Methods】27 patients received MSCT examination for orthotopic liver transplantation by GE Light Speed 16 rows multi-spiral computer tomography. MSCT scan the total liver,from cupular part of diaphragm to the inferior border of kidney with collimation 2.5mm.All patients were intravenously injected nonionic constrast(1.5ml/kg,at 3ml/s).Portal phase was acquired at 70s.We described the circumscription of total liver,right lobe and left lateral lobe,excluded gallbladder and great vessels in ADW 4.2 workstation.The dates of volume were calculated by two methods:area accumulation and three-dimensional reconstruction.The actual volumes were measured by water replacement method.At last,the accuracy of total and segmental liver volume measurement and Pearson coefficient were gained by comparing these two results and actual volumes measured by water replacement.【Results】1 The error of total liver,right lobe and left lateral lobe volume measurement by area accumulation were 10±7%,17±11%and 13±9%.A nearly ideal correlation coefficient(r=0.971,0.949,0.952,P＜0.001)were present.Time consuming was 107±25minute in one case.The error of three-dimensional reconstruction were 9±6%,17±12%and 14±11%.It also showed good correlation(r=0.976,0.946,0.934, P＜0.001).Time consuming was 36±10minute in one case.Compared with TLV,the error of RLV measurement was higher(t=2.922,3.329,P＜0.01).The error of LLV was was higher than TLV in three-dimensional reconstruction(t=2.175,P＜0.05). No significant differents were found between two methods,but the three-dimensional reconstruction was more convenient and less time consuming.2 After we removing 4 patients' dates,which the intervals of MSCT examination and operation time were more than 60 days,the error were 9±7%,16±10%and 10±8%,r=0.981,0.960,0.968,P＜0.001.Error of three-dimensional reconstruction were 7±4%,14±10%and 10±7%,r=0.985,0.961,0.963,P＜0.001.3 It was no significant differents were showed between HCC group and liver cirrhosis group in TLV,RLV and LLV(t=0.99,2.041,0.541,P＞0.05).Same results were found between ascites and no ascites group(t=1.357,1.767,0.836,P＞0.05).4 The formula of LV and CTLV were obtained by liner regression analysis.ATLV=161.743+0.786×CT-LV,ARLV= 99.956+0.749×CT-RLV,ALLV=35.224+0.908×CT-LLV could be used in area accumulation and ATLV=130.597+0.837×3DCT-LV,ARLV=104.775+0.747×3DCT-RLV,ALLV=55.433+0.826×3DCT-LLVshould be used in three-dimensional reconstruction.【Conclusion】MSCT can assess the total liver and hepatic lobes volume accurately.The three-dimensional reconstruction is superior to area accumulation and more convenient and less time consuming in clinical application.The formula can reduce error rate further by correcting dates of liver volume measurement,and have important value in clinic.