螺旋CT增强延迟扫描对肝细胞外间隙定量评估的临床研究  

Contrast Enhanced Delay Scanning of Spiral CT Quantification of the Hepatic Fractional Extracellular Space

作　　者：彭涛[1,2] 陈卫国[1] 彭加友[2] 方挺松[2] 柯祺[2] 秦耿耿[1] 杜钢[1] 

机构地区：[1]南方医科大学南方医院放射科,510515 [2]广州中医药大学附属佛山市中医院放射科

出　　处：《临床放射学杂志》2015年第9期1435-1438,共4页Journal of Clinical Radiology

基　　金：佛山市科技局基金课题(编号:0013193120415024)

摘　　要：目的探讨采用螺旋CT增强延迟扫描对肝细胞外间隙(f ECS)大小进行定量评估的可行性。方法选取因接受尿路造影检查的32名既往无肝脏疾病史的成年人(对照组)以及32例经病理证实的肝纤维化患者(病例组),注射对比剂10分钟后进行延迟扫描,测量其f ECS,并与病理分级对照(分级标准参照慢性乙型肝炎防治指南2010版)。结果对照组f ECS为(29.8±5.6)%,病例组f ECS为(36.9±5.9)%,两者之间的差异具有统计学意义(P<0.0001);根据ROC曲线下面积为0.961时,f ECS与病理分级结果相一致。以f ECS等于30.8%作为肝纤维化的切割点,灵敏度为100.0%,特异度为75.0%。结论螺旋CT增强延迟扫描能够对f ECS的大小进行定量评估,f ECS有可能能够预示肝纤维化的严重程度。Objective To explore the feasibility of using Contrast Enhanced delay scanning of spiral CT Quantification of Hepatic Fractional Extracellular Space. Methods Retrospective review was performed on the data of 32 patients（ 18 men,14women,mean age： 40. 8 ± 5. 4years） without cirrhosis and 32 patients with cirrhosis（ 20 men,12 women,mean age： 41. 2 ± 5. 8years） who had undergone unenhanced and 10 minutes delayed phase contrast enhanced CT. Hepatic fractional ECS was defined as the ratio of the difference between the attenuation of the liver on 10 minutes and unenhanced images to the difference between the attenuation of the aorta on 10 minutes and unenhanced images multiplied by 1 minus the hematocrit. Findings of patients with cirrhosis were correlated with pathologic grading results. Results The mean fractional ECS was significantly greater in patients with cirrhosis than in those without cirrhosis（ 36. 9% ± 5. 9% versus 29.8% ± 5. 6%,P 〈 0. 0001）. The fractional ECS correlated with the pathology grading score and was predictive of cirrhosis with an area under the receiver operating characteristic curve of 0. 961（ P 〈 0. 0001）. The sensitivity and specificity of an expanded fractional ECS greater than 30. 8% for the prediction of cirrhosis were 100% and 75%. Conclusion Contrast Enhanced delay scanning of spiral CT is capable of being used to estimate the fractional ECS. The fractional ECS in patients with cirrhosis correlates with the pathology grading score,and could predict the severity of liver fibrosis.

关 键 词：计算机断层摄影 肝纤维化 定量评估 

分 类 号：R816.5[医药卫生—放射医学] R575[医药卫生—临床医学]