双能量CT定量分析技术对早期急性胰腺炎的诊断价值  

Diagnostic value of dual-energy CT quantitative analysis technique in acute pancreatitis at early stage

作　　者：梅碧 王嵩[1] MEI Bi;WANG Song(Department of Radiology,Longhua Hospital Affiliated of Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China)

机构地区：[1]上海中医药大学附属龙华医院放射科,上海200032

出　　处：《中国中西医结合影像学杂志》2023年第6期610-613,共4页Chinese Imaging Journal of Integrated Traditional and Western Medicine

基　　金：龙医科技创新项目(KY22051)。

摘　　要：目的:评估基于双能量CT(DECT)衍生的碘浓度和脂肪分数定量分析在早期急性胰腺炎(AP)中的诊断价值。方法:纳入40例早期AP患者(AP组),另设对照组(40例),2组均行腹部DECT增强扫描。由2位放射科医师采用双盲法利用常规灰阶DECT图像进行诊断。其中1位医师在DECT材料密度分解图像上手动测量胰腺头部、体部、尾部ROI的碘浓度和脂肪分数,并行ROC曲线分析,判定区分炎性胰腺组织和正常胰腺实质的最佳阈值。结果:AP组的碘浓度为(1.9±0.4)mg/mL,对照组为(2.8±0.6)mg/mL,2组差异有统计学意义(P<0.001);2组脂肪分数差异无统计学意义(P=0.07)。诊断AP的最佳碘浓度阈值为2.2 mg/mL,敏感度94.7%,特异度77.6%,AUC 0.847,显著高于放射科医师的标准图像评估(AUC 0.786,敏感度77.4%,特异度88.7%)。结论:与标准图像相比,DECT获得的碘浓度在早期AP诊断中具有更高的敏感度。Objective:To evaluate the diagnostic value of quantitative analysis of iodine concentration and fat fraction derived from dual-energy CT(DECT)in early stage acute pancreatitis(AP).Methods:A total of 40 patients with early stage AP(the AP group)and 40 controls(the control group)were included,and all patients received abdominal DECT enhancement scans.The diagnosis was made by two physicians using conventional grayscale DECT images.The iodine concentration and fat fraction in ROIs of the pancreatic head,body and tail on DECT material density images were measured,and the ROC curve was analyzed to estimate the optimal threshold for distinguishing inflammatory from normal pancreatic parenchyma.The diagnostic efficiency of the two methods was compared.Results:The iodine concentration of the AP group was(1.9±0.4)mg/mL,that of the control group was(2.8±0.6)mg/mL,and the difference was statistical(P<0.001),while the difference of the fat fraction was not statistical between the two groups(P=0.07).The optimal iodine concentration threshold for the diagnosis of AP was 2.2 mg/mL,the sensitivity was 94.7%,the specificity was 77.6%,and the AUC was 0.847,which were significantly higher than the diagnosis results from the standard images by radiologists(AUC of 0.786,sensitivity of 77.4%,specificity of 88.7%).Conclusions:Compared with the standard images,iodine concentration obtained by DECT has higher sensitivity in the diagnosis of early stage AP.

关 键 词：体层摄影术 X线计算机 胰腺炎 碘定量 诊断 

分 类 号：R576[医药卫生—消化系统]