定量CT测量腹部脂肪面积及分布的重复性研究  

The reproducibility of abdominal fat area and distribution measured by QCT

作　　者：王玲[1] 汪伟[1] 邓微[2] 姜繁 徐杰 赵海竹[1] 徐黎[1] 柏瑞[4] 欧陕兴[4] 嵇辉[5] 程晓光[1] 

机构地区：[1]北京积水潭医院放射科,北京100035 [2]北京积水潭医院内分泌科,北京100035 [3]北京顺义医院放射科,北京101300 [4]广州军区总医院,广州510000 [5]武警总医院放射科,北京100039

出　　处：《中国骨质疏松杂志》2012年第11期999-1003,共5页Chinese Journal of Osteoporosis

基　　金：北京市卫生系统高层次卫生技术人才培养项目(编号:2009-02-03)

摘　　要：目的研究采用定量CT骨密度(QCT)方法测量腹部脂肪面积及分布的重复性。方法以到北京积水潭医院进行腰椎QCT骨密度检查的30例(女15例,男15例)患者为测量对象,采用QCT分析软件中的"tissue composition"功能定量测量L2、L3、L4、L5椎体中心层面的腹部脂肪面积(TAA)及腹内脂肪面积(VAA),两者相减得皮下脂肪面积(SAA)。由3名经过严格培训的放射医生独立进行测量,并记录每次TAA及VAA测量用时。用重复测量方差分析及组内相关系数(ICC)评价3名不同观察者测量间及同一观察者不同时间两次测量的重复性。结果 3名不同测量者及同一测量者前后两次测量L2、L3、L4、L5椎体中心层面TAA及VAA的均值无统计学显著差异(P>0.05);3名测量者及同一测量者两次不同时间测量L2、L3、L4、L5椎体中心层面TAA及VAA测量值之间高度一致(ICC>0.900)。L2、L3、L4、L5椎体中心层面平均SAA/VAA比分别为1.14±0.58、1.46±0.81、2.00±1.08、2.23±1.04。使用该方法测量单层面TAA及VAA所需时间为3～6 min,平均约5 min。结论定量CT测量腹部脂肪具有准确、可重复及快速等特点。该方法在测量椎体骨密度的同时,可区域性、简单、直观的评价皮下及腹内脂肪分布。Objective To assess the reproducibility of QCT in measuring abdominal adipose area and distribution. Methods The total adipose area（TAA） and the visceral adipose area（VAA） in the middle level of L2-L5 vertebra of 30 patients were measured by 3 radiologists independently, and one radiologist measured twice. The tissue composition module of Mindways QCT software was used.. The time spent for every TAA and VAA was recorded. The inter-observer and the intra-observer reproducibility were analyzed using intraclass correlation coefficient （ICC） and repeated-measures ANOVA. Results There was no significant difference among the results of the inter-observer or the intra-observer （ P 〉 0. 05 ）. The inter- observer and the intra-observer reproducibility was excellent（ ICC 〉 0. 900）. The mean SAA/VAA ratio of L2, L3, IA, L5 level were 1.14 ± 0.58,1.46 ± 0. 81,2.00 ± 1.08,2.23 ±1.04 individually. The mean time spent was 5 minutes（3 -6 minutes）. Conclusions QCT is accurate, reproducible, and fast in the analysis of abdominal adiposity. It is a regional and easy technique for evaluation of subcutaneous and visceral fat compartments.

关 键 词：体层摄影术 X线计算机 腹部脂肪 重复性 测量 

分 类 号：R815[医药卫生—放射医学] R68[医药卫生—临床医学]