二代双层探测器光谱CT腹部虚拟平扫诊断脂肪肝的可行性研究  

Feasibility study on second-generation dual-layer detector spectral CT abdominal VNC in diagnosing fatty liver

作　　者：程勇 丁杰豪 张钰 曹城浩 郑卓 彭丽 张潇迪 李真林[1] CHENG Yong;DING Jiehao;ZHANG Yu;CAO Chenghao;ZHENG Zhuo;PENG Li;ZHANG Xiaodi;LI Zhenlin(Department of Radiology,West China Hospital,Sichuan University,Chengdu,Sichuan 610041,China;Philips Clinical Medical Research Division,Chengdu,Sichuan 610000,China)

机构地区：[1]四川大学华西医院放射科,成都610041 [2]飞利浦医疗临床科研部,成都610000

出　　处：《重庆医学》2024年第18期2804-2809,2814,共7页Chongqing Medical Journal

摘　　要：目的探讨二代双层探测器光谱CT腹部虚拟平扫(VNC)诊断脂肪肝的可行性。方法回顾性分析2022年6月至12月在四川大学华西医院放射科采用二代双层探测器光谱CT上行腹部增强CT检查患者128例的影像资料。在真实平扫(TNC)、动脉期VNC(A-VNC)、静脉期VNC(V-VNC)图像上测量所有患者肝脏左叶、右前叶、右后叶、脾脏的CT值,并计算相应时相肝脏CT值与脾脏CT值的差值(L-S)及比值(L/S)。参考以往研究TNC图像诊断脂肪肝的阈值,将纳入病例分为脂肪肝与非脂肪肝两组。采用Mann-Whitney U检验比较脂肪肝组与非脂肪肝组之间定量参数的差异,通过受试者工作特征曲线(ROC)评估VNC诊断脂肪肝的效能,并使用DeLong’s检验比较ROC曲线之间的差异。采用组间相关系数(ICC)评估数据测量的一致性。结果数据的组内及组间一致性ICC值范围分别为0.835~0.986、0.810~0.978(P<0.05)。A-VNC和V-VNC的肝脏左叶、右前叶、右后叶及三叶的平均值和脾脏的CT值均低于TNC,差异均有统计学意义(P<0.05)。非脂肪肝组TNC、A-VNC、V-VNC的CT值、(L-S)值及(L/S)值均高于脂肪肝组,差异均有统计学意义(P<0.05)。A-VNC、V-VNC的CT值诊断脂肪肝的ROC曲线下面积(AUC)均为0.997,诊断效能差异无统计学意义(Z=0.407,P=0.684)。A-VNC(L-S)、V-VNC(L-S)诊断脂肪肝的AUC值分别为1.000、0.981,诊断效能差异无统计学意义(Z=1.790,P=0.074)。A-VNC(L/S)、V-VNC(L/S)诊断脂肪肝的AUC值分别为0.992、0.987,诊断效能差异也无统计学意义(Z=0.665,P=0.506)。结论二代双层探测器光谱CT重建的VNC图像中肝脏、脾脏的CT值低于TNC,但基于VNC图像诊断脂肪肝仍是可行的。Objective To explore the feasibility of second-generation dual-layer detector spectral CT abdominal virtual non-contrast(VNC)for diagnosing fatty liver.Methods The imaging data of 128 patients with second-generation dual-layer detector spectral CT abdominal enhanced CT in West China Hospital of Sichuan University from June 2022 to December 2022 were retrospectively analyzed.The CT values of the left lobe,right anterior lobe,right posterior lobe and spleen of all patients were measured on TNC,arterial stage VNC(A-VNC)and venous stage VNC(V-VNC)images.The difference value(L-S)and ratio value(L/S)between the CT value of liver and CT value of spleen were calculated.According to the threshold value of TNC image diagnosis of fatty liver in previous studies,the included cases were divided into two groups:fatty liver group and non-fatty liver group.The Mann-Whitney U test was used to compare the difference of quantitative parameters between the fatty liver group and non-fatty liver group.The efficiency of VNC in the diagnosis of fatty liver was evaluated by the receiver operating characteristic(ROC)curve,and the difference between ROC curves was compared with DeLong’s test.The intra-group and inter-group correlation coefficient(ICC)values were used to evaluate the consistency of data measurement.Results The ICC values of intra-group and inter-group consistency of data ranged(0.835-0.986)and(0.810-0.978),respectively(P<0.05).The mean value of left lobe,right anterior lobe,right posterior lobe and triple lobe of liver and CT value of spleen in A-VNC and V-VNC images were lower than those of TNC images,and the differences were statistically significant(P<0.05).The CT values of TNC,A-VNC,V-VNC,(L-S)values and(L/S)values of the non-fatty liver group were higher than those of the fatty liver group,and the differences were statistically significant(P<0.05).The CT value,(L-S)value and(L/S)value of TNC,A-VNC and V-VNC images in the non-fatty liver group were higher than those in the fatty liver group,and the differences were st

关 键 词：脂肪肝 体层摄影术 X射线计算机 虚拟平扫 腹部 

分 类 号：R445.3[医药卫生—影像医学与核医学]