摘要目的 利用多层螺旋CT评价并比较成人亲属活体右半肝移植术后不同时间供、受者的正常肝再生情况.方法 亲属活体右半肝移植后123对供、受者纳入研究,入组68例供者和63例受者,利用IQQA-Liver工作站进行肝体积测量.评价肝移植术前多层螺旋CT所测供肝体积与术中实测体积之间的关系,计算并比较肝移植后不同时间供、受者的肝再生率.结果 肝移植术前多层螺旋CT所测全肝体积为(1366.99±234.75)cm3,CT所测右半肝体积(VCT右)为(862.73±175.94)cm3,术中排水法实测供肝体积(V术中)为(654.46±151.23)ml,VCT右与V术中之间呈正相关(r=0.795,P=0.000),其回归方程为V术中=64.949+0.683×VCT右.LDLT术后半个月、1个月、3个月及6个月供者肝再生率分别为(75.85±24.35)％、(93.69±32.88)％、(97.67±18.84)％和(122.73±22.99)％,高于相应时间受者的肝再生率,后者分别为(57.36±28.08)％、(58.54±36.43)％、(48.50±28.89)％和(34.04±23.62)％,差异均有统计学意义(P＜0.05).结论 亲属活体右半肝移植后正常供、受者肝再生模式不同,供者再生更明显、更快.利用多层螺旋CT测量肝体积是评价肝移植后肝再生的有效方法.

abstractsObjective To evaluate and compare liver regeneration between normal donors and recipients at the different stages after right lobe adult living donor liver transplantation (LDLT) using MSCT.Method Sixty-eight living donors and 63 recipients without complications were included in this study.We did CT volumetric measurement of the liver by using IQQA-Liver workstation.The relationship between graft volume measured by preoperative MSCT and intraoperative actual graft volume was evaluated.The liver regenerative ratio at different stages of donors and recipients after LDLT was calculated and compared.Result Preoperative measurement of total liver and grafts resulted in a mean volume of (1366.99 ± 234.75) cm3 (standard deviation) and (862.73 175.94) cm3 (VCT-right),respectively.Intraoperative volume of the grafts was (654.46 ± 151.23) ml (Vintraop).Corresponding pre-and intraoperative data were correlated significantly each other (r =0.795,P=0.000).Vintraop can be calculated with the equation:Vintraop =64.949 + 0.683 VCT-right.There was significantly difference in LRR between donors and recipients at 0.5,1,3 and 6 months after LDLT (P＜ 0.05).Conclusion The patterns of normal liver regeneration between donors and recipients after LDLT are different.The liver of donors regenerates more significantly and quickly than recipients.Liver volumetric measurement by using MSCT is a valid modality to evaluate liver regeneration after LDLT.