The Value of 64slice Spiral CT in Preoperative Assessment of Living Donor in Liver Transplantation_West China Medical Journal

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the Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China;

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Keywords：

供体; 肝移植; 多层CT

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目的:探讨64层螺旋CT在活体肝移植供体术前评估中的临床应用价值。方法:活体肝移植术前对拟捐肝者257例行64层螺旋CT检查。扫描序列包括碘浓度监测扫描,自动触发技术进行的肝动脉期、门脉期以及肝静脉期等3期扫描。延迟扫描时间,动脉期22～25s(中位数23s),门脉期42～53s(中位数47s),肝静脉期65～75s(中位数70s)。对比剂注射模式为5mL/s生理盐水20mL+暂停+4～5mL/s对比剂70～120mL+5mL/s生理盐水30mL。图像后处理包括肝脏管道系统重组和肝体积测量。用多平面重组、最大密度投影和容积再现等方法,显示肝动脉、门脉和肝静脉。活体肝体积测量有全肝体积,包括肝中静脉的右半肝体积和不包括肝中静脉的右半肝体积。在同一扫描时相上,测量肝脏和脾脏的CT值,并计算肝脾CT值比值。结果:拟捐肝者257例中,184例行肝移植手术。其中,179例供体接受不包含肝中静脉的右半肝移植。4例双供肝,1例合肝。全部捐肝供体术后恢复良好,无重大并发症和死亡发生。利用64层螺旋CT可对肝脏进行多时相扫描,以及二维、三维图像重组和肝体积测量。结论:64层螺旋CT多时相扫描,二维、三维图像重组和肝体积测量,可为临床活体肝移植术前的供体影像学评估,提供准确、全面的信息。

Citation： LI Zhenlin,SHUAI Tao,YUAN Yuan,et al.. The Value of 64slice Spiral CT in Preoperative Assessment of Living Donor in Liver Transplantation. West China Medical Journal, 2009, 24(9): 2381-2384. doi: Copy

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12.	夏强.活体肝移植的若干问题思考[J].外科理论与实践,2008,(4):300-303..

1. SCHROEDER T, RADTKE A, KUEHL H, et al. Evaluation of Living Liver Donors wit h an Allinclusive 3D Multidetector Row CT Protocol [J]. Radiology,2006,238 (3) :900-910..
2. JIANG X Z, YAN L N, LI B. Safety of Donor in AdulttoAdult Living Donor Liver Transplantation Using Right Lobe graft[J]. Transplant Proceed,2007;39:50-152..
3. LIU BIN, YAN LUNAN, WANG WT. Clinical study on safety of adulttoadult living donor liver transplantation in both donors and recipients[J]. World J Gastroenterol,2007,13(6):955-959..
4. 姜滨, 祁吉.多层螺旋 CT在活体肝移植手术前后评估中的应用[J]. 国际医学放射学杂志,2008,31(4):243-246..
5. 雷静,宋光义,韩丹,等.多层螺旋 C T在活体肝右叶移植供体术前肝静脉评估中的应用[J]. 实用放射学杂志;2008(24):1499-1511..
6. 赵华丽, 陈克敏.多层螺旋 CT 在活体供肝移植供体术前的应用;诊断学理论与实践,2008(7):228-231..
7. 谢春, 沈文, 祁吉.MSCT对成人活体右半肝移植静脉流出道重建方式的诊断价值[J]. 临床放射学杂志,2009,(28):343-346..
8. 沈文,程悦,杨静.MSCT血管成像在活体肝移植术前评估中的价值[J]. 放射学实践,2009,(24):241-246..
9. CHAN S C, FAN S T, LO C M, et al. Toward current standards of donor right hepatectomy for adulttoadult live donor liver transplantation through the experience of 200cases[J]. Ann Surg,2007,245(1):110-117.
10. ITO T, KIUCHI T, EGAWA H, et al. Surgeryrelated morbidity in living donors of rightlobe liver graft: lessons from the first 200 cases [J]. Transplantation,2003,76(1):158- 163..
11. 严律南.活体肝移植的现状与展望[J].中国普外基础与临床杂志.2007(14):1280-131..
12. 夏强.活体肝移植的若干问题思考[J].外科理论与实践,2008,(4):300-303..

West China Medical Journal

The Value of 64slice Spiral CT in Preoperative Assessment of Living Donor in Liver Transplantation

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