Department of Radiology, Beijing Friendship Hospital, Capital Medical University, 95 Yong'an Rd, Xicheng District, Beijing, China, 100050.
Department of Radiology, Hospital of Shunyi District, Beijing, China.
AJR Am J Roentgenol. 2020 Mar;214(3):665-670. doi: 10.2214/AJR.19.22035. Epub 2020 Jan 22.
The purpose of this study was to evaluate the value of dual-energy CT (DECT) in assessing liver hemodynamics in children with cholestatic cirrhosis. The cases of 60 children with cholestatic cirrhosis (study group) and 15 children with inherited metabolic diseases but normal liver function (control group) were retrospectively evaluated. Enhanced CT scans were obtained in spectral imaging mode. Iodine concentration (IC) of hepatic parenchyma in the arterial phase (IC) and portal venous phase (IC) was measured on iodine-water material decomposition images. The hepatic arterial iodine fraction (AIF) was calculated as: = / . The IC, IC, and AIF of children in the control and study groups were analyzed by one-way ANOVA and post hoc test with Bonferroni correction. The radiation dose was recorded. There were differences in IC and AIF between the control and study groups. The values in patients in the Child-Pugh class C group were the highest and those in the control group the lowest ( < 0.05). Statistically significant differences in IC were not found ( > 0.05). Specifically, the multiple comparison results indicated that there were differences in both IC and AIF in most of the groups ( < 0.05). The volume CT dose index value for all patients was the same at 10.14 mGy for each enhanced phase, and the total dose-length product varied between 402.68 and 679.18 mGy-cm. IC and AIF obtained at dual-energy CT can be used as semiquantitative indicators to evaluate the liver hemodynamics of children with cholestatic cirrhosis.
本研究旨在评估双能 CT（DECT）在评估胆汁淤积性肝硬化儿童肝血流动力学中的价值。回顾性分析了 60 例胆汁淤积性肝硬化患儿（研究组）和 15 例肝功能正常的遗传性代谢疾病患儿（对照组）的病例。采用能谱成像模式进行增强 CT 扫描。在碘水物质分解图像上测量动脉期（IC）和门静脉期（IC）肝实质碘浓度（IC）。肝动脉碘分数（AIF）计算为：= / 。采用单因素方差分析和 Bonferroni 校正的事后检验分析对照组和研究组儿童的 IC、IC 和 AIF。记录辐射剂量。对照组和研究组之间的 IC 和 AIF 存在差异。Child-Pugh 分级 C 组患儿的数值最高，对照组患儿的数值最低（<0.05）。IC 无统计学差异（>0.05）。具体来说，多重比较结果表明，大多数组的 IC 和 AIF 均存在差异（<0.05）。所有患者的容积 CT 剂量指数值在每个增强期均为 10.14 mGy，剂量长度乘积在 402.68 至 679.18 mGy-cm 之间变化。DECT 获得的 IC 和 AIF 可作为半定量指标，用于评估胆汁淤积性肝硬化儿童的肝血流动力学。
