CT平扫定量测量胰腺脂肪含量的临床应用价值  

Application value of quantitative assessment of pancreatic fat by CT

作　　者：韩广[1] 孟祥福[1] 范欣[2] 王雪[3] HAN Guang;MENG Xiangfu;FAN Xin;WANG Xue(Department of Medical Imaging,Chinese Medicine Hospital in Linyi City,Linyi,276000,China)

机构地区：[1]山东省临沂市中医医院医学影像科,山东临沂276000 [2]山东省临沂市中医医院康复科,山东临沂276000 [3]山东省临沂市中医医院超声科,山东临沂276000

出　　处：《中国中西医结合影像学杂志》2018年第2期159-162,共4页Chinese Imaging Journal of Integrated Traditional and Western Medicine

摘　　要：目的:评价手术切除胰腺标本脂肪含量与CT测量指标的相关性,并分析其用于评估临床糖代谢异常的价值。方法:回顾性分析78例行胰腺切除术并于术前1个月内接受CT检查患者的临床和影像学资料,其中男54例,女24例,年龄21~79岁,平均63.5岁。测量手术切除标本胰腺非肿瘤组织的胰腺脂肪含量,以视野中脂肪面积占整个视野面积百分比表示。在CT平扫图像上测量胰腺和脾的平均CT值,计算胰腺与脾CT值差值(P-S)及胰腺与脾CT值比值(P/S)。选择脐水平层面测量腹腔内脏脂肪面积。利用Spearman相关分析判断CT测量指标、内脏脂肪面积与组织标本胰腺脂肪含量的相关性;采用多变量Logistic回归模型确定CT测量指标、年龄、性别、内脏脂肪含量与糖代谢异常(如糖耐量受损、空腹血糖异常或糖尿病)的相关性。结果:组织病理学上胰腺脂肪含量为0~68.4%,与P-S、P/S显著相关(均P<0.01)。内脏脂肪面积与胰腺脂肪含量无显著相关性(P=0.52)。在年龄、性别和内脏脂肪面积调整后,CT测量指标仍是预测糖代谢受损的显著性独立影响因素。结论:CT可定量测量胰腺脂肪含量,CT值量化的胰腺脂肪含量化与糖代谢异常显著相关。Purpose:To investigate the relationship between CT indexes and histologically measured pancreatic fat in surgical specimens and to assess the application value of CT indexes in evaluating patients with impaired glucose metabolism in a clinical setting.Methods:78 patients(54 men and 24 women;mean age,63.5 years;age range,21～79 years old)who underwent CT within 1 month before pancreatectomy were enrolled in this retrospective study.The histologic pancreatic fat fraction(area ratio of fat to total tissue times 100%)was measured in nontumorous pancreatic tissue.Attenuation was measured in the pancreas and the spleen on nonenhanced CT images.The difference between pancreatic and splenic attenuation(P-S)and the pancreas-to-spleen attenuation ratio(P/S)were calculated.Visceral fat area at the level of the umbilicus was measured on the CT images.Spearman correlation coefficients(r)were calculated to examine the correlation between the CT indexes or visceral fat area and the histologic pancreatic fat fraction.A multivariate logistic regression model was used to determine whether CT attenuation indexes and patient age,sex,and visceral fat correlated with impaired glucose metabolism(ie,impaired glucose tolerance,impaired fasting glucose,or presence of diabetes).Results:The histologic pancreatic fat fraction ranged from 0%to 68.4%and was significantly correlated with the difference between pancreatic and splenic attenuation(r=-0.653,P<0.01)and the pancreas-to-spleen attenuation ratio(r=-0.646,P<0.01).The visceral fat area was not correlated with the histologic pancreatic fat fraction(r=0.101,P=0.52).The CT attenuation indexes were significant and independent variables predictive of impaired glucose metabolism after adjusting for age,sex,and visceral fat.Conclusion:Pancreatic fat can be quantified by using CT,and CT attenuation indexes that are applied to the quantification of pancreatic fat are significantly associated with clinical assessment of impaired glucose metabolism.

关 键 词：胰腺 胰腺切除术 脂肪 体层摄影术 X线计算机 

分 类 号：R576[医药卫生—消化系统] R816.5[医药卫生—内科学]