术前无创检查评估肝脏储备功能在肝癌治疗中的应用进展

Preoperative Non-Invasive Examination to Evaluate the Application of Liver Reserve Function in the Treatment of Liver Cancer

摘要: 肝癌是我国第4位常见恶性肿瘤，其治疗首选肝切除术，而术后肝功能衰竭(PHLF)是肝癌术后发生重大并发症及患者死亡的重要原因，目前其临床发生率仍很高，因此术前准确评估患者肝脏储备功能对预防PHLF至关重要。传统评估术前肝功能储备方法(如：Child评分、CT等)对存在不同肝病基础的患者准确度欠佳，而无创检查由于创伤小，并发症少受到临床重视，近些年临床应用的吲哚菁绿(ICG)检查、肝弹性成像，三维重建技术、残肝体积计算及核医学等功能学显像技术能同时对术后残余肝体积(RLV)和残余肝功能进行评估，较传统评估方法更具优势。

Abstract: Liver Neoplasms is the fourth common malignant tumor in China, and its treatment is preferred by hepatectomy, but postoperative liver failure (PHLF) is an important cause of major complications and death of patients after liver cancer surgery, and its clinical incidence is still very high, so accu-rate assessment of liver reserve function in patients before surgery is very important to prevent PHLF. Traditional methods for assessing preoperative liver function reserve (such as Child score, CT, etc.) are not accurate for patients with different liver disease bases, while non-invasive examination has received little clinical attention due to small trauma and complications, and in recent years, the clinical application of indocyanine green (ICG) examination, liver elasticity imaging techniques, three-dimensional reconstruction technology, residual liver volume calculation and nuclear medi-cine and other functional imaging techniques can evaluate the residual liver volume (RLV) and re-sidual liver function at the same time, which has more advantages than traditional assessment methods.