The Value Of MSCT Post-processing Technology In The Diagnosis Of Liver Cirrhosis

Background and SignificancesChild-Pugh classification of the current clinical application in assessment method on liver function is used for the majority of liver disease, but in recent years, the liver volume has become an important quantitative index evaluation liver cirrhosis degree, through the measurement of liver volume can be helpful in determining the severity of liver disease and the course of disease, but because of the impact of individual factors, physical health and disease factors and so on, so one cannot accurately assess liver volume size by using the methods of physical examination, measurement of volume as the "gold standard" is only used in the drainage of isolated liver volume measurement of liver volume, cannot be used for measurement of the size of the in vivo. In twentieth Century 80 early Heymsfield et al first published using CT measurement of liver volume in vivo, found that the measurement accuracy is maintained at +5%, shows the positive effect of CT in vivo measurement of liver volume in. In recent years, multi slice spiral CT (Multi-slice spiral CT, MSCT) especially the application of 64 slice spiral CT, significantly improve the image quality of CT, but also the organizational structure of micro display more clearly, and it has the technology of 3D reconstruction of the powerful, not only has more advantages in the diagnosis of many diseases of the body also, for the measurement of liver volume in vivo, preoperative evaluation of liver functional reserve provides an important choice.ObjectivesTo make the measurement of liver volume by multi-slice spiral CT and three-dimensional reconstruction of post processing technique, study of multi-slice spiral CT post-processing technique which is a noninvasive means in the diagnosis of liver cirrhosis value.Materials and Methods1. SubjectsThe research select the hospital in 2013 October -2014 year in October science examination confirmed by clinical examination, physical examination, laboratory examination and imaging in patients with liver cirrhosis and 108 cases as case group, in accordance with the case, control standard frequency ratio of 1:1,108 cases were selected, and the gender and age difference in less than 2 years old, after 64 slice spiral CT inspection found no liver lesions and without a history of hepatic disease as control group.2The evaluation methods of the case group admission examination and liver functionGive full physical assessment examination in 108 cases of liver cirrhosis in hospital, and to evaluate the liver function.3 Multi slice spiral CT scan and three-dimensional reconstruction method of post processing technologyAll of the subjects were selected in this study underwent multislice spiral CT scan, multislice spiral CT scan parameters for 120kV,200～300mA, thickness 0.5mm, pitch 1, multilayer spiral CT scanning range is along the lower pole of the dome of the diaphragm has to double kidney, advanced scan, and then enhanced scan.4 Liver volume measurement methodIn 64 slice spiral CT workstations CT image volume rendering (volume rendering technique, VRT), and combined with the threshold method and the layer cutting method for measurement of liver volume and records. Liver volume data is obtained, and then converted into the surface area per unit volume of liver.5 Physical measurements:Measurements of height and weight.6 Investigation methodThis survey with access to medical records, laboratory examination, multi-slice spiral CT examination and physical measurement method of combining the investigation.7 Follow up:To meet the operation of portal hypertension in patients with cirrhosis surgical indications for surgery, and then on the surgical treatment of patients for a period of 1 years of follow-up, records of patients with liver function, causes abnormal circumstances, the time of death and death.8Entry and statistical analysis of data:The data were input with Epidata 3 software to establish database, data were analyzed by SPSS 19.0 statistical software. For continuous variables, the results to mean+ standard deviation (mean+SD) representation; classification variable to the number of cases (percentage (N);%) said. Test of T compared with small sample data of two groups of measurement data, compared with a plurality of groups of measurement data and analysis of variance of two two, compared with the SNK test; comparison of count data using chi square test. Standard test is significant to take the bilateral alpha=0.05, P< 0.05 had statistical significance.Results1The general situation of cases and control groupA total of 108 cases patients, including 58 cases of male, female 50 cases, mean age (54.50+8.61); the control group of 108 cases, including 58 cases of male, female 50 cases, mean age (52.36+8.15) years, two groups of subjects of gender matching, by statistical testing found no statistical difference in age distribution of two groups (t=1.083, P=0.283), two groups of data balance thus selected is good, comparable.2 Cases patients by Child-Pugh method the results obtained by classificationIn this study,108 cases of group of patients, are classified according to Child-Pugh method, get the Child-Pugh in 48 cases of Grade A,40 cases of Child-Pugh grade B,20 cases of Child-Pugh grade C,3The repeatability of multi-slice spiral CT post-processing technique in liver volume measurementWith statistical difference between the statistical tests were not found in every CT testing personnel two measurements and 2 CT testing personnel measurement results (P> 0.05), so the precision measurement of liver volume data of this study high, reliable results, good repeatability.4The case group Child-Pugh classification and comparison groups before and after the standard liver volumeLiver volume before standardization, found that there was significant difference between the control group, the Child-Pugh class A, Child-Pugh, Child-Pugh grade B grade C four group data average liver volume (F= 111.120, P=0.000), but Child-Pugh was not found in a grade and Child-Pugh grade B has significant difference (P> 0.05), there were significant differences between the other groups, with Child-Pugh grade, the average volume of liver is more and more small. After the standard liver volume, also have significant difference between four groups of data of the average liver volume (F=84.757, P=0.000), as the Child-Pugh level increased, the average volume of liver is also getting smaller and smaller.5.15 cases of liver cirrhosis patients in the preoperative grading operation results of Child-Pugh method and preoperative liver volume measurement resultsConclusions1 Multi slice spiral CT post processing precision liver volume measurement data with high technology, reliable results, good repeatability.2 As the Child-Pugh level increased, the average volume of liver is also getting smaller and smaller.3 Multi-slice spiral CT post-processing technique measurement of liver volume is more sensitive than Child-Pugh grade of liver function, accurate, reliable assessment index.