Application Value Of CT The Liver Volume Measurement At The Resection Of Liver Cancer And Liver Cirrhosis Patients With Child-Pugh Classfication

Objective:Through the way of grouping, Use of CT examination forHealthy subjects and Patients with cirrhosis, Using CT of the liver volumereconstruction technology observed in patients with cirrhosis of the livermorphology change, for patients with cirrhosis of the liver function C-Pclassification assessment, Compared with clinical outcome, DiscussesApplication value of CT the liver volume measurement at the liver cirrhosispatients with Child-Pugh classification; At the same time using CT hepaticreconstruction technology, measurement Preoperative and postoperative livervolume of liver cancer patients, Compared with clinical outcome, At the sametime, analysis of the residual liver volume and the relationship between thepostoperative liver function damage, Which provide more accurate informationfor the surgical treatment and help more effectively.Object: Collected in October2013to February2015in Jilin universityNO.1hospital between abdominal CT enhancement was proved by Laboratoryresults, and no other of lesions in the liver cirrhosis patients, A total of97cases,65cases of male, female32cases, And at the same time, collected without liverdisease itself or cause liver morphology change of other diseases but for otherreasons for abdominal CT enhancement of patients as control group, A total of95cases, These patients are using Siemens Dual Source CT (DSCT) to inspect,Select scan plus three phase scanning procedure is enhanced, Also collectedbetween December2013to February2015, Proved by pathology In JiLinuniversity NO.1hospital Completed the radical resection of primary liver cancerpatients, A total of39cases,21cases of male, female18cases, They use the same inspection instrument and scanning program like patients with cirrhosisbefore.Materials and Methods: Patients must sign a consent form before they dothe CT examination,And do breath training to reduce the artifacts producedduring the inspection. through The elbow midline intravenous contrastmedium(Iopromide370or Omnipaque350)90ml,Then10ml of normal salineinjections, Injection rate of3ml per second, For arterial after scanning started30s,60s to balance period,120s for the delay.According to the patients with cirrhosis liver function C-P classificationthey divide three groups, A level31cases,(20cases of male,11case offemale),B level43cases (30caces of male and13cases of female),C lvevl21cases (14cases of male,8cases of famale), The control group patients into threegroups according to age,20to35years old (group A, A total of27cases,14cases of male,13cases of female),35to50years old (group B, A total of46cases,21cases of male,25cases of female),50-65years old (group C, A total of22cases,9cases of male and13cases of female),using workstation Volumesoftware to get the image of the liver Volume reconstruction, Using the softwareautomatically measuring data. Contrast the differences between patients withdifferent groups.Before scanning measurement The patient’s height and weight, Calculatethe patient’s body surface area BSA,(BSA（m2）=0.0071×BH（cm）+0.0133×BW（kg)-0.1971)[1], Calculate the standard liver volume of patients SLV,SLV(SLV=613×BSA(m2)+162.8)[2].Use the workstation volume software to doThe liver volume reconstruction to On preoperative of primary liver cancer wereexamined by abdominal CT enhancement of the image, Measuring the total livervolume forecasting, surgical resection of liver volume and residual liver volume,And record the above data, Calculate the residual liver volume rate, Then usewater displacement method to measure the intraoperative resection of liver tissue and tumor, compared with preoperative predicted resection of livervolume. On the other hand, collect patients with Preoperative three days and twoweeks after surgery laboratory examination indexes, Such as albumin, totalbilirubin, cholinesterase and prothrombin, etc, Do C-P classification respectively,Compare the preoperative and postoperative results, according this, Divided thepatients into the postoperative liver function damage to deepen and liverfunction damage not deepen group.Results: compare between the different cirrhosis groups, liver volume’snarrow Always as cirrhosis of the liver disease increased., Total liver volume ofpatients with cirrhosis is Negatively correlated withC-P classification. compare Liver cirrhosis group and the control group,The left hepatic lobe and caudate lobe volume increased significantly, Comparethe difference between two groups have statistical significance (p <0.05);Totalliver, left lobe and right lobe volume shrink significantly, Compare thedifference between two groups have statistical significance (p <0.05). In thecontrol group, Total liver volume is negative correlation with age, And closelyrelative to body weight and body surface area.Calculate the standard liver volume of the selected39patients with primaryliver cancer in the preoperative,it’s753cm3-2085cm3,an average of1590±290cm3,Using CT of the liver volume reconstruction to calculate totalliver volume is796cm3-1688cm3, an average of1420±226cm3, Standard livervolume and CT reconstruction of the proceeds of the liver volume comparedstatistically difference (p <0.05).in the above patient, A total of17patients inthe postoperative use the water displacement method to measure theintraoperative actual resection of liver volume, compared with predict resectionof liver volume which was calculating by preoperative CT of the liver volumereconstruction technology, Calculates accuracy, Compared the two is notstatistically significant (p>0.05).With two weeks after reviewing liver function grade of C-P, Compared with the preoperative C-P classification, A total of12cases of postoperative liver function damage increased, Residual liver volume ata rate average of54%±22%; Postoperative liver function damage not deepen atotal of27cases，Residual liver volume at a rate average of70%±11%，Data tocompare the two groups have statistical significance (p <0.05).Conclusion: In physiological state, the liver volume is decreases with age,increases with the BSA or weight. Patients with cirrhosis of the left hepatic lobeand the caudate lobe will increase, Left inside, right, and total liver volume willdecrease, and the reduce and cirrhosis of the liver disease progression arenegative correlation.CT of the liver volume reconstruction technology can be fast and accuratemeasurement of primary liver cancer preoperative total liver volume andpredicted resection of liver volume and residual liver volume, in preoperativeclinical doctors to develop according to the scope of the resection operationmethod has a certain guiding role. Residual liver volume rate and postoperativeliver function damage are negative, it Is an important index of liver functionalrecovery prediction.