低剂量胸部CT平扫对贫血的诊断效能研究  

A Study of the Diagnostic Efficacy of Low-Dose Chest CT Plain Scanning for Anemia

作　　者：魏创维 赵文婧 汤泽辉 刘东婷 张楠 刘家祎 温兆赢 徐磊 WEI Chuangwei;ZHAO Wenjing;TANG Zehui(Department of Radiology,Beijing Anzhen Hospital,Capital Medical University,Beijing Institute of Heart,Lung and Blood Vessel Disease,Beijing 100029,P.R.China)

机构地区：[1]首都医科大学附属北京安贞医院,北京市心肺血管疾病研究所医学影像科,北京100029

出　　处：《临床放射学杂志》2025年第5期856-861,共6页Journal of Clinical Radiology

基　　金：国家自然科学基金面上项目(编号:82071880);国家自然科学基金青年基金项目(编号:82202139)。

摘　　要：目的与胸部常规剂量CT(CDCT)平扫比较,评价低剂量CT(LDCT)平扫诊断贫血的准确性,并探索最佳诊断参数。方法回顾性搜集接受CDCT和LDCT检查的贫血和非贫血患者各45例。所有患者在CT检查前后24 h内均测量了外周血血红蛋白(Hb)含量。测量室间隔(IVS)CT值和左心室心腔(LV)CT值,并计算室间隔与左心室心腔CT值差值(CT值_(IVS-LV))和室间隔与左心室心腔CT值的比值(CT值_(IVS/LV))。通过Pearson和Spearman相关分析,评估两组CT值_(LV)、CT值_(IVS-LV)和CT值_(IVS/LV)与Hb之间的关系,再利用受试者工作特征曲线(ROC)分析,获得最佳的指标阈值,并比较不同指标之间诊断贫血的准确性。结果LDCT组及CDCT组CT值_(LV)、CT值_(IVS-LV)和CT值_(IVS/LV)与Hb之间均呈中-高度相关(LDCT组:r_(CT值_(LV))=0.552,r_(CT值_(IVS-LV))=-0.753,r_(CT值_(IVS/LV))=-0.758,P值均<0.01;CDCT组:r_(CT值_(LV))=0.69,r_(CT值_(IVS-LV))=-0.854,r_(CT值_(IVS/LV))=-0.854,P值均<0.01)。CT值_(IVS/LV)诊断贫血的准确性在两组中均最高(AUC_(LDCT组)=0.895,P<0.01;AUC_(CDCT组)=0.946,P<0.01)。在LDCT组,当CT值_(IVS/LV)cut-off=1.135时,诊断贫血的敏感度、特异度、阳性预测值和阴性预测值分别为80.0%、86.7%、85.7%和81.3%;在CDCT组,当CT值_(IVS/LV)cut-off=1.115时,诊断贫血的敏感度、特异度、阳性预测值和阴性预测值分别为91.1%、86.7%、87.2%和90.7%。结论LDCT诊断贫血的准确性与CDCT相近,特异性一致,敏感性稍差。在CT值_(LV)、CT值_(IVS-LV)和CT值_(IVS/LV)三个指标中,CT值_(IVS/LV)诊断贫血的准确性在LDCT扫描中最高。Objective To evaluate the accuracy of low-dose computed tomography(LDCT)scanning for the diagnosis of anemia and to explore the optimal diagnostic parameters in comparison with conventional-dose computed tomography(CDCT)scanning of the chest.Methods A total of 45 anemic and 45 non-anemic patients who underwent both CDCT and LDCT were retrospectively collected.Peripheral blood hemoglobin(Hb)levels were measured within 24 hours before and after the CT examination for all patients.The CT values of the interventricular septum(IVS)and left ventricular cavity(LV)were measured,and the differences(IVS-LV)and ratios(IVS/LV)of these CT values were calculated.Pearson and Spearman correlation analyses were used to assess the relationships between CT_(LV) value,CT_(IVS-LV) value,CT_(IVS-LV) value,and Hb levels in both groups.Receiver operating characteristic(ROC)curves were then used to determine the optimal threshold values for these indices and to compare their diagnostic accuracy for anemia.Results Both the LDCT and CDCT groups showed moderate-to-high correlations between CT_(LV) value,CT_(IVS-LV) value,and CT_(IVS-LV) value with Hb levels(LDCT group:r for CT_(LV) value=0.552,r for CT_(IVS-LV) value=-0.753,r for CT_(IVS-LV) value=-0.758,all P<0.01;CDCT group:r for CT_(LV) value=0.69,r for CT_(IVS-LV) value=-0.854,r for CT_(IVS-LV) value=-0.854,all P<0.01).The CT_(IVS-LV) value had the highest diagnostic accuracy for anemia in both groups(AUC for LDCT group=0.895,P<0.01;AUC for CDCT group=0.946,P<0.01).In the LDCT group,when the CT_(IVS-LV) value cutoff was 1.135,the sensitivity,specificity,positive predictive value,and negative predictive value for diagnosing anemia were 80.0%,86.7%,85.7%,and 81.3%,respectively.In the CDCT group,when the CT_(IVS-LV) value cutoff was 1.115,the corresponding values were 91.1%,86.7%,87.2%,and 90.7%,respectively.Conclusion The diagnostic accuracy of LDCT for anemia is similar to that of CDCT,with consistent specificity but slightly lower sensitivity.Among the three indices(CT_(LV) value,CT_(IV

关 键 词：贫血 低剂量CT 血红蛋白 

分 类 号：R445[医药卫生—影像医学与核医学]