Schaudinn Alexander, Linder Nicolas, Garnov Nikita, Kerlikowsky Felix, Blüher Matthias, Dietrich Arne, Schütz Tatjana, Karlas Thomas, Kahn Thomas, Busse Harald
Department of Diagnostic and Interventional Radiology, Leipzig University Hospital, Leipzig, Germany; Integrated Research and Treatment Center (IFB) AdiposityDiseases, Leipzig University Medical Center, Leipzig, Germany.
NMR Biomed. 2015 May;28(5):583-90. doi: 10.1002/nbm.3286. Epub 2015 Mar 25.
The quantification of visceral adipose tissue (VAT) is increasingly being considered for risk assessment and treatment monitoring in obese patients, but is generally time-consuming. The goals of this work were to semi-automatically segment and quantify VAT areas of MRI slices at previously proposed anatomical landmarks and to evaluate their predictive power for whole-abdominal VAT volumes on a relatively large number of patients. One-hundred and ninety-seven overweight to severely obese patients (65 males; body mass index, 33.3 ± 3.5 kg/m(2); 132 females; body mass index, 34.3 ± 3.2 kg/m(2)) underwent MRI examination. Total VAT volumes (VVAT-T ) of the abdominopelvic cavity were quantified by retrospective analysis of two-point Dixon MRI data (active-contour segmentation, visual correction and histogram analysis). VVAT-T was then compared with VAT areas determined on one or five slices defined at seven anatomical landmarks (lumbar intervertebral spaces, umbilicus and femoral heads) and corresponding conversion factors were determined. Statistical measures were the coefficients of variation and standard deviations σ1 and σ5 of the difference between predicted and measured VAT volumes (Bland-Altman analysis). VVAT-T was 6.0 ± 2.0 L (2.5-11.2 L) for males and 3.2 ± 1.4 L (0.9-7.7 L) for females. The analysis of five slices yielded a better agreement than the analysis of single slices, required only a little extra time (4 min versus 2 min) and was substantially faster than whole-abdominal assessment (24 min). Best agreements were found at intervertebral spaces L3-L4 for females (σ5/1 = 523/608 mL) and L2-L3 for males (σ5/1 = 613/706 mL). Five-slice VAT volume estimates at the level of lumbar disc L3-L4 for females and L2-L3 for males can be obtained within 4 min and were a reliable predictor for abdominopelvic VAT volume in overweight to severely adipose patients. One-slice estimates took only 2 min and were slightly less accurate. These findings may contribute to the implementation of analytical methods for fast and reliable (routine) estimation of VAT volumes in obese patients.
在肥胖患者的风险评估和治疗监测中，内脏脂肪组织（VAT）的量化越来越受到重视，但通常耗时较长。这项工作的目标是在先前提出的解剖学标志处半自动分割和量化MRI切片的VAT区域，并在相对大量的患者中评估其对全腹VAT体积的预测能力。197名超重至重度肥胖患者（65名男性；体重指数，33.3±3.5kg/m²；132名女性；体重指数，34.3±3.2kg/m²）接受了MRI检查。通过对两点Dixon MRI数据进行回顾性分析（主动轮廓分割、视觉校正和直方图分析），对腹腔盆腔的总VAT体积（VVAT-T）进行量化。然后将VVAT-T与在七个解剖学标志（腰椎间隙、脐部和股骨头）定义的一片或五片切片上确定的VAT区域进行比较，并确定相应的转换因子。统计指标为预测VAT体积与测量VAT体积之差的变异系数以及标准差σ1和σ5（Bland-Altman分析）。男性的VVAT-T为6.0±2.0L（2.5 - 11.2L），女性为3.2±1.4L（0.9 - 7.7L）。五片切片的分析比单片切片的分析一致性更好，只需要多一点时间（4分钟对2分钟），并且比全腹评估（24分钟）快得多。女性在L3 - L4椎间间隙（σ5/1 = 523/608mL）和男性在L2 - L3椎间间隙（σ5/1 = 613/706mL）处发现了最佳一致性。女性在L3 - L4椎间盘水平和男性在L2 - L3椎间盘水平的五片VAT体积估计可在4分钟内获得，并且是超重至重度肥胖患者腹腔盆腔VAT体积的可靠预测指标。单片估计仅需2分钟，准确性稍低。这些发现可能有助于实施肥胖患者VAT体积快速可靠（常规）估计的分析方法。
