Section of Radiological Sciences, Department of Biomedical Sciences and Morphological and Functional Imaging, University of Messina, Policlinico "G. Martino", Via Consolare Valeria 1, 98100, Messina, Italy.
Department of Radiology, "Sapienza" University of Rome, Rome, Italy.
Radiol Med. 2021 Jun;126(6):761-767. doi: 10.1007/s11547-021-01341-z. Epub 2021 Mar 14.
Fractional extracellular space has been validated as a marker of hepatic fibrotic in cirrhotic patients at CT-scan as well as on dual-energy CT, which takes advantage from iodine uptake. Since no consensus still exists between equilibrium phases performed at 3 or 10 min, the first aim of this work is to evaluate performances at the two different time points. Moreover, correlation between fractional extracellular space and oesophageal varices, directly related to liver fibrosis, has been assessed.
Dual-Energy equilibrium phases at 3 and 10 min were performed within a follow-up CT-protocol scan in cirrhotic patients. Oesophageal varices were endoscopically assessed according to their size. At the two different time points, correlation between iodine density of the right and left liver lobes and correlation between the fractional extracellular space values were assessed. Correlation between fractional extracellular space and endoscopic grade of oesophageal varices was calculated.
No statistical differences were found between the iodine density values from the two liver lobes at the two time points (p = 0.8 at 3'; p = 0.5 at 10'). No statistical difference about fractional extracellular space estimation was found between the two time points (p = 0.17). Correlation between fractional extracellular space values and oesophageal varices was moderate (ρ = 0.45, IC 0.08-0.71, p < 0.05).
Fractional extracellular space assessed on dual-energy CT at equilibrium phases with different timing was substantially similar. The moderate correlation found between fractional extracellular space and endoscopic grade of oesophageal varices confirms that CT-scan is not currently reliable as endoscopy.
在 CT 扫描以及双能 CT 上，细胞外空间分数已被验证为肝硬化患者肝纤维化的标志物，这得益于碘的摄取。由于在 3 分钟和 10 分钟的平衡期之间仍未达成共识，这项工作的首要目标是评估这两个不同时间点的表现。此外，还评估了细胞外空间分数与食管静脉曲张之间的相关性，食管静脉曲张与肝纤维化直接相关。
在肝硬化患者的 CT 随访方案扫描中进行了双能平衡期 3 分钟和 10 分钟。根据食管静脉曲张的大小进行内镜评估。在两个不同的时间点，评估了右肝和左肝叶碘密度之间的相关性，以及细胞外空间分数值之间的相关性。计算了细胞外空间分数与食管静脉曲张内镜分级之间的相关性。
在两个时间点，两个肝叶的碘密度值之间没有统计学差异（3'时 p = 0.8；10'时 p = 0.5）。两个时间点之间细胞外空间分数的估计值没有统计学差异（p = 0.17）。细胞外空间分数值与食管静脉曲张之间存在中度相关性（ρ = 0.45，IC 0.08-0.71，p < 0.05）。
在不同时间的双能 CT 平衡期评估的细胞外空间分数基本相似。细胞外空间分数与食管静脉曲张内镜分级之间的中度相关性证实，CT 扫描目前不如内镜可靠。
