三维重建脾脏体积客观评估ICG

3D Reconstruction of Spleen Volume for Objective Assessment of ICG

摘要: 背景：肝切除是治疗肝癌的关键手段。术前评估肝功能储备则是肝切除的必经之路。吲哚菁绿(ICG)清除率试验是肝切除术前评估肝脏储备功能的主要方法，但由于部分患者有不良反应，给临床工作带来了避免不了的麻烦；脾脏体积与肝硬化病人的肝切除有着密切关系，那么，脾脏体积与ICG是否也有着某种联系？方法：我们回顾性分析300例肝硬化行肝切除的患者，探讨影响肝储备功能的危险因素，通过SPSS逻辑回归建立模型，并用ROC检验其模型准确性。结果：通过脾脏体积、白蛋白、总胆红素、年龄构建出逻辑回归模型，得出脾脏体积是ICG的独立危险因素，并进一步通过ROC得出模型的AUC为0.877，敏感度为84%，特异度为80%。结论：通过三维重建脾脏体积求得ICG 15分钟滞留率(ICG-R15)，更好地服务于临床医生，从而评估术前肝储备功能，进而决定是否可行手术治疗。

Abstract: Background: Hepatectomy is a key treatment for liver cancer. Preoperative evaluation of liver function reserve is a necessary step in liver resection. The indocyanine green (ICG) clearance rate test is the main method for evaluating liver reserve function before liver resection, but due to some patients having adverse reactions, it brings unavoidable troubles to clinical work; There is a close relationship between splenic volume and liver resection in patients with liver cirrhosis. Therefore, is there also some connection between splenic volume and ICG? Method: We retrospectively analyzed 300 patients with liver cirrhosis who underwent liver resection, explored the risk factors affecting liver reserve function, established a model through SPSS logistic regression, and tested the accuracy of the model with ROC. Result: A logistic regression model was constructed based on spleen volume, albumin, total bilirubin, and age, and it was found that spleen volume is an independent risk factor for ICG. Furthermore, the AUC of the model was determined to be 0.877, with a sensitivity of 84% and a specificity of 80%. Conclusion: ICG 15-minute retention rate (ICG-R15) was obtained by three-dimensional reconstruction of spleen volume to better serve clinicians, thereby assessing preoperative liver reserve function and determining the feasibility of surgical treatment.