能谱CT物质分离技术在非酒精性脂肪肝患者定量评估的价值研究  

Quantitative value of energy spectrum CT material separation technology in nonalcoholic fatty liver

作　　者：张敏 马光明[1,2] 段海峰 于楠[1,2] 杨创勃 ZHANG Min;MA Guangming;DUAN Haifeng;YU Nan;Yang Chuangbo(Department of Medical Imaging,the Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine,Xianyang,Shaanxi Province 712000,China;Shaanxi University of Chinese Medicine,Xianyang,Shaanxi Province 712046,China)

机构地区：[1]陕西中医药大学附属医院医学影像科,陕西咸阳712000 [2]陕西中医药大学,陕西咸阳712046

出　　处：《实用放射学杂志》2024年第2期231-234,共4页Journal of Practical Radiology

基　　金：陕西中医药大学学科创新团队建设项目(2019QN-09)。

摘　　要：目的探讨能谱CT物质分离技术量化评估非酒精性脂肪肝患者的可行性,并比较其与常规肝/脾CT比值对肝脏脂肪含量分级的精确性。方法选取非酒精性脂肪肝患者60例及正常志愿者20例,分别进行肝脏MR多回波(ME)Dixon和能谱CT扫描,并分别测量其质子密度脂肪分数(PDFF)、脂肪浓度(FC)及肝/脾CT比值。根据PDFF将非酒精性脂肪肝患者分为轻度脂肪肝组、中度脂肪肝组和重度脂肪肝组。结果随着PDFF升高,FC升高,肝/脾CT比值降低,正常组、轻度脂肪肝组、中度脂肪肝组、重度脂肪肝组FC各组间差异有统计学意义(P<0.05),而正常组和轻度脂肪肝组的肝/脾CT比值差异无统计学意义(P>0.05)。受试者工作特征(ROC)曲线分析表明,当FC临界值为351.19 mg/mL时,对正常组和脂肪肝组的敏感度、特异性和曲线下面积分别为0.95、1.0和0.99。结论能谱CT物质分离技术与MR ME Dixon测定的脂肪含量有很好的相关性,优于肝/脾CT比值测定的脂肪含量。对于非酒精性脂肪肝患者,能谱CT中的FC对鉴别正常和轻度脂肪肝具有较高的准确性。Objective To investigate the feasibility of energy spectrum CT material separation technology for quantitative evaluation of nonalcoholic fatty liver patients,to compare the accuracy of this method with the conventional liver/spleen CT ratio for grading liver fat content.Methods Sixty patients diagnosed with nonalcoholic fatty liver and 20 healthy volunteers were chosen to undergo liver MR multi-echo(ME)Dixon and energy spectrum CT scans.The proton density fat fraction(PDFF),fat concentration(FC),and liver/spleen CT ratio were then measured for each participant.According to PDFF,nonalcoholic fatty liver patients were divided into mild fatty liver group,moderate fatty liver group,and severe fatty liver group.Results With the increase in PDFF,FC increased and the liver/spleen CT ratio decreased.The difference between FC groups in normal,mild,moderate and severe fatty liver groups was statistically significant(P<0.05),while the difference between the liver/spleen CT ratio of normal group and mild fatty liver group was not statistically significant(P>0.05).The receiver operating characteristic(ROC)curve analysis showed that when the critical value of FC was 351.19 mg/mL,the sensitivity,specificity and area under the curve for normal group and fatty liver group were 0.95,0.1 and 0.99,respectively.Conclusion The energy spectrum CT material separation technology has a good correlation between the fat content measured by the MR ME Dixon,which is superior to the fat content measured by the liver/spleen CT ratio.For patients with nonalcoholic fatty liver,FC in energy spectrum CT has high accuracy in differentiating normal and mild fatty liver.

关 键 词：非酒精性脂肪肝 定量评估 磁共振成像 能谱CT物质分离技术 

分 类 号：R575.5[医药卫生—消化系统] R445.2[医药卫生—内科学] R814.42[医药卫生—临床医学]