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光谱 CT:肝硬化的初步研究。

Spectral CT: preliminary studies in the liver cirrhosis.

机构信息

Department of Radiology, The First Affiliated Hospital of Zhengzhou University, Henan Province 450052, China.

出版信息

Korean J Radiol. 2012 Jul-Aug;13(4):434-42. doi: 10.3348/kjr.2012.13.4.434. Epub 2012 Jun 18.

Abstract

OBJECTIVE

To investigate the value of spectral CT imaging in the diagnosis and classification of liver cirrhosis during the arterial phase (AP) and portal venous phase (PVP).

MATERIALS AND METHODS

Thirty-eight patients with liver cirrhosis (Child-Pugh class A/B/C: n = 10/14/14), and 43 patients with healthy livers, participated in this study. The researchers used abdominal spectral CT imaging during AP and PVP. Iodine concentration, derived from the iodine-based material-decomposition image and the iodine concentration ratio (IC(ratio)) between AP and PVP, were obtained. Statistical analyses {two-sample t test, One-factor analysis of variance, and area under the receiver operating characteristic curve (A [z])} were performed.

RESULTS

The mean normalized iodine concentration (NIC) (0.5 ± 0.12) during PVP in the control group was significantly higher than that in the study group (0.4 ± 0.10 on average, 0.4 ± 0.08 for Class A, 0.4 ± 0.15 for Class B, and 0.4 ± 0.06 for Class C) (All p < 0.05). Within the cirrhotic liver group, the mean NIC for Class C during the AP (0.1 ± 0.05) was significantly higher than NICs for Classes A (0.1 ± 0.06) and B (0.1 ± 0.03) (Both p < 0.05). The IC(ratio) in the study group (0.4 ± 0.15), especially for Class C (0.5 ± 0.14), was higher than that in the control group (0.3 ± 0.15) (p < 0.05).The combination of NIC and IC(ratio) showed high sensitivity and specificity for differentiating healthy liver from cirrhotic liver, especially in Class C cirrhotic liver.

CONCLUSION

Spectral CT Provides a quantitative method with which to analyze the cirrhotic liver, and shows the potential value in the classification of liver cirrhosis.

摘要

目的

探讨能谱 CT 成像在肝硬化患者肝动脉期(AP)和门静脉期(PVP)诊断和分类中的价值。

材料与方法

本研究纳入 38 例肝硬化患者(Child-Pugh 分级 A/B/C:n=10/14/14)和 43 例健康肝脏者。采用腹部能谱 CT 成像进行 AP 和 PVP 检查。获取碘基物质分解图像上的碘浓度及 AP 与 PVP 碘浓度比值(IC(ratio))。采用两样本 t 检验、单因素方差分析和受试者工作特征曲线下面积(A [z])进行统计学分析。

结果

对照组 PVP 时平均碘标准化浓度(NIC)(0.5±0.12)显著高于研究组(平均 0.4±0.10,A 级为 0.4±0.08,B 级为 0.4±0.15,C 级为 0.4±0.06)(均 P<0.05)。在肝硬化组内,AP 时 C 级的平均 NIC(0.1±0.05)显著高于 A 级(0.1±0.06)和 B 级(0.1±0.03)(均 P<0.05)。研究组的 IC(ratio)(0.4±0.15),尤其是 C 级(0.5±0.14),高于对照组(0.3±0.15)(P<0.05)。NIC 和 IC(ratio)联合可提高鉴别健康肝脏与肝硬化肝脏的敏感性和特异性,尤其是在 C 级肝硬化肝脏。

结论

能谱 CT 提供了一种定量分析肝硬化的方法,显示了在肝硬化分类中的潜在价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bebb/3384825/b26c61da7fcb/kjr-13-434-g001.jpg

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