双能量CT碘定量参数在评估肠道克罗恩病病变活动性中的应用价值  

Application Of Iodine Quantificationin Evaluatingactivity of Crohn’s Diseaseusing Dual-Energy CT

作　　者：陈建秋 朱建国[1] 李燕[1] 李海歌[1] 郭浩东 毛良强 温泉 崔伯塔[2] CHEN Jianqiu;ZHU Jianguo;LI Yan(Department of Radiology of the Second Affiliated Hospital of Nanjing Medical University,Nanjing,Jiangsu Province 210011,P.R.China)

机构地区：[1]南京医科大学第二附属医院医学影像科,210011 [2]南京医科大学第二附属医院消化医学中心,210011

出　　处：《临床放射学杂志》2022年第3期505-509,共5页Journal of Clinical Radiology

基　　金：江苏省卫健委高层次卫生人才“六个一工程”(编号:LGY2018072);江苏省高等学校自然科学研究项目(编号:18KJB310007)。

摘　　要：目的探讨双能量CT(DECT)碘定量参数(IQ)在评估肠道克罗恩病病变活动性中的应用价值。方法采用回顾性研究方法,搜集肠道克罗恩病患者71例。所有患者接受DECT检查,采集DECT的参数包括:动脉期相对碘浓度、静脉期相对碘浓度、延迟期相对碘浓度3个定量参数,同时搜集患者的人口学资料(年龄、性别),临床资料(简易内镜评分),实验室血清学资料(C反应蛋白、红细胞沉降率)。依据简化版的克罗恩病临床活动性评分(Harvey-Bradshaw index,HBI)将患者分为3组(活动缓解组、中度活动组和重度活动组)。运用Kruskal-Wallis H检验比较DECT碘定量参数组间差异;将多参数纳入有序Logistic回归分析,研究在克罗恩病活动性判别中的作用;DECT碘定量参数和简易内镜评分相关性检验采用Spearman检验。结果随病变活动性增加,动脉期相对碘浓度(P<0.001)、静脉期相对碘浓度(P<0.001)、C反应蛋白(P=0.008)、红细胞沉降率(P=0.017)显著升高。有序Logistic回归显示动脉期、静脉期相对碘浓度是区分克罗恩病活动性的独立危险因素。DECT参数:动脉期相对碘浓度(r=0.293,P=0.013)、静脉期相对碘浓度(r=0.186,P=0.012)与克罗恩病简易内镜评分呈正相关。结论双能量CT碘定量参数与简易内镜评分有关,有助于克罗恩病活动性的判别。Objective To evaluate the role of Dual-energy Computed tomography(DECT)iodine quantification(IQ)in evaluating the activity of Crohn’s disease(CD).Methods A retrospective study was conducted in 71 patientswith intestinal CD.All patients were examined by DECT.The parameters of DECT included:normalized iodine concentration(NIC)in arterial phase,relative iodine concentration in venous phase and relative iodine concentration in delayed phase.Meanwhile,the clinical data of patients,such as age,gender,simplified endoscopic score for Crohn’s disease(SES-CD),clinical symptoms and signs were collected C-reactive protein(CRP),erythrocyte sedimentation rate(ESR).Patients were divided into three groups(remission group,moderate activity group and severe activity group)according to the simplified version of the Harvey Bradshaw index(HBI).Kruskal-Wallis H test was used tocompare the differences of iodine quantitative parameters of DECT between groups;Multiple parameters were included in the ordinal logistic regression analysis to study the role in the identification of Crohn’s disease activity;Spearman test was used to test the correlation between DECT iodine quantitative parameters and SES-CD.Results The NIC in arterial phase(P<0.001),venous phase(P<0.001),CRP(P=0.008)and ESR(P=0.017)increased significantly with the aggravation of disease activity.Ordinal logistic regression showed that the NIC in arterial phase and venous phase was an independent risk factor to distinguish the activity of Crohn’s disease.DECT parameters:NIC in arterial phase(r=0.293,P=0.013),NIC in venous phase(r=0.186,P=0.012)were positively correlated with SES-CD.Conclusion The iodine quantitative parameters of DECT are related to SES-CD,which is helpful to distinguish the activity of Crohn’s disease.

关 键 词：双能量CT 动脉期相对碘浓度 静脉期相对碘浓度 克罗恩病 活动性 Harvey-Bradshaw指数 克罗恩病简易内镜评分 

分 类 号：R816.5[医药卫生—放射医学] R574.62[医药卫生—临床医学]