能谱CT成像应用于肝硬化Child-Pugh分级  

Child-Pugh Grading in Cirrhosis Patients with Spectral CT

作　　者：江帆[1] 邓克学[1] 赵娜[1] 唐皓[1] 

机构地区：[1]安徽医科大学附属省立医院影像科

出　　处：《中国医学计算机成像杂志》2015年第1期48-52,共5页Chinese Computed Medical Imaging

摘　　要：目的:探讨宝石CT能谱成像(gemstone spectral imaging,GSI)的多点多参数分析在肝硬化ChildPugh分级中的应用价值。方法:58例肝硬化患者(Child-Pugh分级:A级20例,B级20例,C级18例)纳入研究,采用能谱CT进行GSI三期增强扫描,测量并计算动脉期肝左叶、右叶、尾状叶及门脉期肝左叶、右叶、尾状叶、门脉主干、脾脏的标准化碘浓度,计算能谱曲线斜率,按分级比较。运用ROC曲线评估诊断效能,分别计算以碘浓度比、能谱曲线斜率为诊断指标的敏感度及特异度。结果:动脉期各参数各级间没有显著性差异(P≥0.05)。门脉期门静脉标准化碘浓度值A级(1.169±0.093)显著高于C级(1.098±0.097,P=0.026);脾脏标准化碘浓度值A、B、C级分别为0.689±0.068、0.633±0.086、0.549±0.138,两两比较差异有统计学意义(P均<0.05);门脉能谱曲线斜率A级(3.723±0.894)显著高于C级(3.028±0.536,P=0.007);脾脏能谱曲线斜率A、B、C级分别为1.711±0.197、1.706±0.433、1.392±0.479,A、B级分别与C级间有显著性差异(PAC=0.015,PBC=0.042)。分别选择合适的诊断阈值,可使上述敏感度及特异度均达到60.0%及以上。结论:CT能谱成像并多点多参数分析有助于临床进行肝硬化程度分级。Purpose： To explore the value of multi-spot and multi-parameter study with gemstone spectral imaging （GSI） in Child-Pugh grading of cirrhotic patients. Methods： Totally 58 patients with liver cirrhosis underwent triple-phase enhanced CT scans by GSI mode. Among them, 20 cases were in grade A, 20 cases were in grade B, 18 cases were in grade C. Normalized iodine concentration （NIC）, spectral curves, slope rates of left, right and caudate lobe of liver in arterial phase and portal phase, portal vein and spleen in portal phase were measured and compared respectively among three grades. The diagnostic performances were evaluated by ROC analysis. Results： There was no significant difference between any parameter of any grade in arterial phase （all P≥0.05）. NIC of grade A of portal vein in portal phase （1.169±0.093） was higher than that of grade C （1.098±0.097, P=0.026）; NIC of grade A, B, C of spleen in portal phase was 0.689 ± 0.068, 0.633 ± 0.086, 0.549 ± 0.138 respectively. There were significant differences between each two groups （all P〈0.05）; Slope rate of grade A of portal vein in portal phase （3.723± 0.894） was higher than that of grade C observably（3.028±0.536, P=0.007）; Slope rate of grade A, B, C of spleen in portal phase was 1.711±0.197, 1.706±0.433, 1.392±0.479 respectively. There were significant differences between grade A and grade C, grade B and grade C. （pAc=0.015,PBc=0.042）. When appropriate threshold values were taken, all the sensitivity and specificity was greater than or equal to 60.0%. Conclusion： Multi-spot and mult- parameter study with GSI may be helpful in grading the liver cirrhosis.

关 键 词：能谱成像 体层摄影术 X线计算机 肝硬化 Child分级 

分 类 号：R575.2[医药卫生—消化系统] R816.5[医药卫生—内科学]