应用64层螺旋CT探讨脾体积的简易估测方法

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目的运用64层螺旋CT测量成人正常脾体积(splenic volume,SP)及容积相关参数,探讨SP与生理参数的关系及SP的简易估测方法。资料与方法对无明确脾疾病的120例受检者行64层螺旋CT腹部增强扫描,针对层厚2mm、重组间隔2mm的门静脉期图像进行分析。采用Siemens Volume体积测量软件测定脾的体积值,并测定脾上下径、左右径、前后径、厚度和最大截面积。对测量结果进行统计分析。结果120例受检者的平均脾体积为(203±79)cm3。平均脾上下径、左右径、前后径、厚度和最大截面积分别为(9.0±1.7)cm、(9.1±1.0)cm、(9.5±1.9)cm、(3.8±0.7)cm和(35.6±9.5)cm2。体积与身高、体重存在较弱的正相关关系,与年龄间存在较弱的负相关关系。消除了体重因素的影响后,不同性别组间SP无显著差异。SP与脾上下径(r=0.7887,P<0.01)及脾最大截面积(r=0.8641,P<0.01)均具有很好的正相关性。简化的回归方程为:脾体积=0.616×脾上下径×脾最大截面积(t=109.7,r2=0.9906,P<0.01)。脾增大的诊断标准为SP>358cm3。结论SP与各种生理参数间相关性不强,绝对体积值>358cm3可诊断为脾增大。通过测量CT像上脾上下径与最大横截面积,可以简单、迅速而较准确地估测SP。 Objective To evaluate the relationship between SP and physiological parameters and the simple estimation method of SP by using 64-slice spiral CT to measure adult splenic volume (SP) and volume related parameters. Materials and Methods 120 cases of subjects without definite spleen disease underwent enhanced abdominal CT scan with 64-slice spiral CT, and the images of portal vein with 2mm thickness and 2mm interval were analyzed. The volume of spleen was measured by Siemens Volume Volumetric Measurement software and the upper and lower spleen diameter, left and right diameter, anteroposterior diameter, thickness and maximum cross-sectional area were measured. Statistical analysis of measurement results. Results The average spleen volume of 120 subjects was (203 ± 79) cm3. The average upper and lower spleen diameter, left and right diameter, anteroposterior diameter, thickness and maximum cross-sectional area were (9.0 ± 1.7) cm, (9.1 ± 1.0) cm, (9.5 ± 1.9) cm, (3.8 ± 0.7) cm and (35.6 ± 9.5) ) cm2. Volume and height, weight there is a weak positive correlation, and there is a weak negative correlation between age. After eliminating the influence of body weight, there was no significant difference in SP between different sex groups. SP had good positive correlation with the upper and lower spleen diameter (r = 0.7887, P <0.01) and the maximum spleen area (r = 0.8641, P <0.01). The simplified regression equation is: spleen volume = 0.616 × upper and lower spleen × spleen maximum cross-sectional area (t = 109.7, r2 = 0.9906, P <0.01). Splenomegaly diagnostic criteria for SP> 358cm3. Conclusion The correlation between SP and various physiological parameters is not strong, the absolute volume value> 358cm3 can be diagnosed as splenomegaly. SP can be estimated simply, quickly and accurately by measuring the upper and lower splenic and maxillary cross-sectional areas of the spleens on CT images.
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