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KMID : 1131320150170020087
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Journal of Korean Society of Computed Tomographic Technology
2015 Volume.17 No. 2 p.87 ~ p.95
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Liver donor transplantation in LDLT (Living Donor liver transplatation) in CT volumetry measurement of Evaluation: Optimization and comparative analysis obtained from 2D and 3D metod
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Lee Hyeong-Sun
Kim Myeong-Seong
Jeong Jong-Sung
Kim Myeong-Gu
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Abstract
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Purpose : For the treatment of patients with chronic liver disease is necessary in living donor transplantation as essential, which depending on preoperative measurement of donor’s liver size. Therefore, to find a evaluate and usefulness, which of accurate preoperative measurement of right lobe liver sizing, is known two-dimensional computed tomography (2D CT) and applying new 3D CT method.
Meterial and method : The subjects were from March 2014 to February 2015 for Hepato Biliary / CTA to donors who underwent living donor liver transplantation, 30 (19 men, 11 women) and mean age is 36 years (17 - 61 years). To find a usefulness of 2D and 3D CT method was compared with excised volume from right lobe of liver by surgery (Graft weight). In this study, using CT equipment was General Electric health care system (GE) 64 Channel (Discovery CT 750 HD) and 4.5 cc / sec speed contrast agent injected with the earl artery, late artery and the portal phase were scanned. Right lobe of liver volumetry were performed on 2D and 3D mehods respectively in 3.75 / 3mm cross-sectional/Interval scanned portal phase by GE’ s Advantage Workstation (Ver 4.6.05). Conventional method, 2D CT Volumetry was to be measured in the contour of all of the each cross-sectional liver images, but 3D CT Volumetry was loading with volume rendering, and obtained liver total volume after cut off the liver vessel and blood CT images as using threshold value of liver parenchyma set, and then obtained right lobe of liver from cut-off based on the mid hepatic vein.
Result : The excised average on weight of the donor liver parenchyma by surgery was 648.56±146.58 cm3, mean 775.76±162.04mm3 as using a 2D CT measurement method, but mean applied to 3D CT measurement method as704.03±156.64cm3. Applied with method of 2D CT measurement, showed average 127.2cm3 wight (t-test,p=0.002) difference from the excise dliver, but differences in55.46cm3(t-test,p=0.16), when compared with 3D CT measurement method. Theres ult of pears on correlation analysis when compared with Graftweight, 0.944 (p<0.001) in 2D CT, but 0.977 (p<0.001) in 3D CT that more correlate with Graf tweight.
Conclusion : Result of liver volumetry measurements method based on CT images is can vary depending on the skill of understanding who conducting anatomical measurements and using 3D Software ski ll. However in case of using a 3D CT measuring methods, present the more accuracy liver weight with GRWR whether determine living liver transplantation than using conventional 2D CT measurement method.
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KEYWORD
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LDLT, GRWR, 3D CT, 2D Volumetry, 3D Volumetry
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