能谱CT容积参数联合肝脏体积预测肝硬化食管静脉曲张出血  

Spectrum CT Volumetric Parameters Combined with Liver Volume Predict Esophageal Variceal Bleeding in Cirrhosis

作　　者：郭钰 徐媛 史佳丽 杨新梅 张宏瑜 刘建莉[1,2,3,4] GUO Yu;XU Yuan;SHI Jia-li;YANG Xin-mei;ZHANG Hong-yu;LIU Jian-li(Department of Radiology,the Second Hospital of Lanzhou University,Lanzhou 730030,Gansu Province,China;Key Laboratory of Medical Imaging of Gansu Province,Lanzhou 730030,Gansu Province,China;The Second Clinical School,Lanzhou University,Lanzhou 730030,Gansu Province,China;Gansu International Science and Technology Cooperation Base for Artificial Intelligence in Medical Imaging,Lanzhou 730030,Gansu Province,China)

机构地区：[1]兰州大学第二医院放射科 [2]甘肃省医学影像重点实验室 [3]兰州大学第二临床医学院 [4]医学影像人工智能甘肃省国际科技合作基地,甘肃兰州730030

出　　处：《中国CT和MRI杂志》2025年第3期119-122,共4页Chinese Journal of CT and MRI

基　　金：甘肃省卫生行业科研计划优秀青年人才和骨干人才项目(GSWSQN2023-04);兰州大学第二医院"萃英研究生导师"培养计划项目(CYDSPY202003)。

摘　　要：目的探讨能谱CT容积定量参数对肝硬化食管静脉曲张出血(EVB)的预测价值。方法回顾性分析2022年12月至2023年9月在本院行门静脉能谱CT增强扫描的73例肝硬化食管静脉曲张患者的临床及影像资料,其中未出血组41例,出血组32例。以单因素分析及多因素Logistic回归分析筛选EVB的临床、实验室检查指标、常规CT表现及增强门脉期能谱CT容积定量参数相关独立预测因素,构建回归模型。绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC),评估独立预测因素及回归模型对EVB的预测效能。结果血红蛋白(HGB)、红细胞压积(HCT)、标准化肝脏体积比(SLVR)和70keV单能量CT值均为肝硬化EVB的独立预测因素(OR=1.145、0.526、0.949、0.925,P=0.035、0.009、0.010、0.021),其预测EVB的AUC分别为0.736、0.769、0.661和0.657,回归模型的AUC为0.868。结论能谱CT容积参数联合实验室指标对肝硬化食管静脉曲张破裂出血具有较好的预测效能,有助于临床治疗的选择。Objective To investigate the predictive value of quantitative spectrum CT volume parameters for esophageal variceal bleeding(EVB)in cirrhosis.Methods Clinical and imaging data of 73 patients with cirrhotic esophageal varices who underwent portal vein energy spectrum CT enhancement scanning at our hospital from December 2022 to September 2023 were retrospectively analyzed,including 41 cases in the non-bleeding group and 32 cases in the bleeding group.Independent predictors related to clinical and laboratory examination indexes,routine CT performance and quantitative parameters of enhanced portal spectrum CT volume of EVB were screened by univariate analysis and multifactorial logistic regression analysis,and regression models were constructed.The ROC curves were plotted,and the area under the curve(AUC)was calculated to evaluate the predictive efficacy of the independent predictors and regression model for EVB.Results Hemoglobin(HGB)、Hematocrit(HCT)、Standard liver volume ratio(SLVR)and 70keV single-energy CT value were independent predictors of EVB in cirrhosis(OR=1.145,0.526,0.949,0.925,P=0.035,0.009,0.010,0.021),and their AUCs for predicting EVB were 0.736,0.769,0.661,and 0.657,respectively.The AUC of the regression model was 0.868.Conclusion Spectrum CT volumetric parameters combined with laboratory indices have good predictive efficacy for ruptured esophageal variceal hemorrhage in cirrhosis and help in the choice of clinical treatment.

关 键 词：食管静脉曲张出血 能谱CT 容积分析 肝脏体积 

分 类 号：R571[医药卫生—消化系统]