Centre for Medical Imaging, University College London, 250 Euston Road, London, NW1 2PG, UK.
Institute of Cardiovascular Science, University College London, London, WC1E 6BT, UK.
Abdom Radiol (NY). 2017 Nov;42(11):2646-2651. doi: 10.1007/s00261-017-1194-4.
To investigate equilibrium contrast-enhanced CT (EQ-CT) measurement of extracellular volume fraction (ECV) in patients with systemic amyloid light-chain (AL) amyloidosis, testing the hypothesis that ECV becomes elevated in the liver and spleen and ECV correlates with other estimates of organ amyloid burden.
26 patients with AL amyloidosis underwent EQ-CT, and ECV was measured in the liver and spleen. Patients also underwent serum amyloid P (SAP) component scintigraphy with grading of liver and spleen involvement. Mann-Whitney U test was used to test for a difference between patients with amyloid deposition (SAP grade 1-3) and those without (SAP grade 0). Variation in ECV across SAP grades was assessed using the Kruskal-Wallis test and association between ECV and SAP grades with Spearman correlation.
Mean ECV in the spleen and liver was significantly greater (p < 0.0005) in amyloidotic organs (SAP grade 1-3) [spleen, liver: 0.430, 0.375] compared with healthy tissues [spleen, liver: 0.304, 0.269]. ECV increased with increasing amyloid burden, showing positive correlation with SAP grade in both the liver (r = 0.758) and spleen (r = 0.867).
In patients with systemic AL amyloidosis, EQ-CT can demonstrate increased spleen and liver ECV, which is associated with amyloid disease burden.
探讨系统性轻链淀粉样变（AL）患者的平衡对比增强 CT（EQ-CT）细胞外容积分数（ECV）测量，检验 ECV 在肝脾中升高的假说，并探讨 ECV 与其他器官淀粉样变负荷估计值的相关性。
26 例 AL 淀粉样变患者接受 EQ-CT 检查，并测量肝脾 ECV。患者还接受血清淀粉样蛋白 P（SAP）成分闪烁扫描，并对肝脾受累进行分级。采用曼-惠特尼 U 检验比较有淀粉样沉积（SAP 分级 1-3）和无淀粉样沉积（SAP 分级 0）患者之间的差异。采用 Kruskal-Wallis 检验评估 ECV 在 SAP 分级中的变化，采用 Spearman 相关分析评估 ECV 与 SAP 分级之间的关系。
淀粉样变器官（SAP 分级 1-3）[脾脏、肝脏：0.430、0.375]的脾脏和肝脏 ECV 明显高于健康组织[脾脏、肝脏：0.304、0.269]（p<0.0005）。ECV 随淀粉样变负荷增加而增加，在肝脏（r=0.758）和脾脏（r=0.867）中与 SAP 分级呈正相关。
在系统性 AL 淀粉样变患者中，EQ-CT 可显示脾脏和肝脏 ECV 增加，与淀粉样变疾病负担相关。
