利用光谱肝脏 CT 中的碘映射进行肝纤维化分级和细胞外体积分数评估。
Hepatic fibrosis grading with extracellular volume fraction from iodine mapping in spectral liver CT.
机构信息
Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea; Department of Radiology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03087, Republic of Korea; Institute of Radiation Medicine, Seoul National University Medical Research Center, 103 Daehak-ro, Jongno-gu, Seoul, 03087, Republic of Korea.
Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea; Department of Radiology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03087, Republic of Korea; Institute of Radiation Medicine, Seoul National University Medical Research Center, 103 Daehak-ro, Jongno-gu, Seoul, 03087, Republic of Korea.
出版信息
Eur J Radiol. 2021 Apr;137:109604. doi: 10.1016/j.ejrad.2021.109604. Epub 2021 Feb 16.
PURPOSE
To determine whether hepatic extracellular volume fraction (ECV) obtained from iodine density map (ECV-iodine) can be used to estimate hepatic fibrosis grade and to compare performance with ECV measured using Hounsfield units (ECV-HU).
METHODS
From December 2016 to March 2019, patients who underwent liver resection or biopsy within four weeks after spectral liver CT were included. ECV-iodine and ECV-HU were calculated using the equilibrium phase. Within each of these, comparison of ECVs was made for different fibrosis grades (F0 - 1 vs. F2 - 3 vs. F4) and also for patients with compensated and decompensated cirrhosis. The diagnostic performance of ECVs in detecting clinically significant fibrosis (≥ F2) and cirrhosis (F4) was assessed using ROC analysis.
RESULTS
A total of 144 patients (men = 98, mean age 58.1 ± 11.5 years) were included. The ECV-iodine value was significantly higher in cirrhosis (33.6 ± 6.8 %) than those with F0 - 1 (25.0 ± 3.7 %) or F2 - 3 (28.3 ± 3.4 %, P < 0.001 for all). It was significantly higher in decompensated cirrhosis than those with compensated cirrhosis (36.5 ± 7.2 % vs. 30.7 ± 5.0 %, respectively; P < 0.001). The AUC of ECV-iodine was 0.82 for detecting F2 or above (cut-off value, > 26.9 %) and 0.81 for detecting cirrhosis (cut-off value, > 29 %). ECV-iodine had a significantly higher AUC than ECV-HU for detecting F2 or above (AUC: 0.69, P < 0.001) and cirrhosis (AUC: 0.74, P = 0.04).
CONCLUSIONS
ECV-iodine from spectral CT was able to detect clinically significant hepatic fibrosis and cirrhosis.
目的
确定从碘密度图（ECV-碘）获得的肝细胞外体积分数（ECV）是否可用于估计肝纤维化程度，并与使用亨氏单位（ECV-HU）测量的 ECV 进行比较。
方法
从 2016 年 12 月至 2019 年 3 月，纳入在光谱肝脏 CT 后四周内接受肝切除术或活检的患者。使用平衡相计算 ECV-碘和 ECV-HU。在这些相中的每一个中，都对不同纤维化程度（F0-1 与 F2-3 与 F4）以及代偿性和失代偿性肝硬化患者的 ECV 进行了比较。使用 ROC 分析评估 ECV 在检测临床显著纤维化（≥F2）和肝硬化（F4）中的诊断性能。
结果
共纳入 144 例患者（男性 98 例，平均年龄 58.1±11.5 岁）。肝硬化患者的 ECV-碘值（33.6±6.8％）明显高于 F0-1 或 F2-3 患者（分别为 25.0±3.7％和 28.3±3.4％，P<0.001）。失代偿性肝硬化患者的 ECV-碘值明显高于代偿性肝硬化患者（分别为 36.5±7.2％和 30.7±5.0％，P<0.001）。ECV-碘检测 F2 或以上（截断值>26.9％）的 AUC 为 0.82，检测肝硬化（截断值>29％）的 AUC 为 0.81。ECV-碘检测 F2 或以上（AUC：0.69，P<0.001）和肝硬化（AUC：0.74，P=0.04）的 AUC 均明显高于 ECV-HU。
结论
光谱 CT 的 ECV-碘能够检测出临床显著的肝纤维化和肝硬化。
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