用于确定肝脏动态 CT 碘剂量的最佳体表面积指数：一项前瞻性多中心研究。
The Optimal Body Size Index with Which to Determine Iodine Dose for Hepatic Dynamic CT: A Prospective Multicenter Study.
机构信息
From the Department of Diagnostic Radiology, Institute of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan (K.A., Y.N.); Department of Radiology, Gifu University Hospital, Gifu, Japan (M.K.); Department of Radiology, Osaka University Graduate School of Medicine, Suita, Japan (T.K., A.N.); Department of Radiology, University of Yamanashi, Chuo, Japan (T.I.); Memorial Heart Center, Iwate Medical University, Morioka, Japan (K.Y.); Department of Radiology, Ehime University School of Medicine, Toon, Japan (T.M.); Department of Radiology, Yamaguchi University School of Medicine, Ube, Japan (N.M.); and Department of Diagnostic Radiology, Kumamoto University, Kumamoto, Japan (Y.Y.).
出版信息
Radiology. 2016 Mar;278(3):773-81. doi: 10.1148/radiol.2015142941. Epub 2015 Sep 10.
PURPOSE
To identify the body size parameter that exhibits the best correlation with aortic and hepatic enhancement at hepatic dynamic computed tomography (CT) in a large patient population enrolled in a multicenter study.
MATERIALS AND METHODS
This prospective study was approved by the ethics committee of each of the 31 participating institutions where 1342 patients were enrolled between April 2012 and September 2013. All patients provided either written or oral informed consent. All patients underwent hepatic dynamic CT, which included preenhanced, hepatic arterial phase (HAP), and portal venous phase (PVP) scanning, performed with the routine scanning protocol of each institution. Changes in CT number (in Hounsfield units) per gram of iodine in the aorta (eA/I) and liver (eL/I) during HAP and PVP scanning were recorded for each patient. Hierarchical multivariate linear regression analysis was performed in which the outcome variable was either eA/I or eL/I; the independent variables were age, sex, one body size parameter (height, body weight, body mass index, lean body weight [LBW], or body surface area), and liver function (aspartate aminotransferase, albumin, and total bilirubin levels). A two-level hierarchical model in which patients were level 1 and the institution was level 2 was used.
RESULTS
Hierarchical multivariate linear regression analysis revealed that in the population not stratified by sex, body size was significantly correlated with eA/I and eL/I (P < .001) and that LBW exhibited the strongest correlation with eA/I and eL/I (r = -0.561 and r = -0.601, respectively). Sex-stratified analysis showed that LBW was more strongly correlated with eA/I and eL/I in women (r = -0.779 and r = -0.948, respectively) than in men (r = -0.500 and r = -0.494, respectively) or in the nonstratified total population.
CONCLUSION
Among body size parameters, LBW exhibited the strongest correlation with aortic and hepatic enhancement, especially in women.
目的
在一项多中心研究中，确定在大型患者人群中，与体部 CT 动脉期和门静脉期肝增强具有最佳相关性的体尺寸参数。
材料与方法
本前瞻性研究获得了 31 个参与机构的伦理委员会的批准，2012 年 4 月至 2013 年 9 月间共有 1342 例患者参与了该研究。所有患者均提供了书面或口头知情同意书。所有患者均行肝部动态 CT 检查，包括增强前、肝动脉期（HAP）和门静脉期（PVP）扫描，扫描方案采用各机构的常规方案。记录每位患者 HAP 和 PVP 扫描期间主动脉（eA/I）和肝脏（eL/I）碘含量每克 CT 值（以亨氏单位表示）的变化。采用分层多元线性回归分析，因变量为 eA/I 或 eL/I，自变量为年龄、性别、一个体尺寸参数（身高、体重、体质量指数、去脂体重[LBW]或体表面积）和肝功能（天冬氨酸转氨酶、白蛋白和总胆红素水平）。采用患者为一级、机构为二级的两级分层模型。
结果
分层多元线性回归分析显示，在未按性别分层的人群中，体尺寸与 eA/I 和 eL/I 显著相关（P＜0.001），LBW 与 eA/I 和 eL/I 的相关性最强（r=-0.561 和 r=-0.601）。性别分层分析显示，LBW 与 eA/I 和 eL/I 的相关性在女性中更强（r=-0.779 和 r=-0.948），在男性中（r=-0.500 和 r=-0.494）或非分层总人群中则较弱。
结论
在体尺寸参数中，LBW 与主动脉和肝脏增强的相关性最强，尤其是在女性中。
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