Kameda Fumi, Tanabe Masahiro, Higashi Mayumi, Ariyoshi Shoko, Ihara Kenichiro, Iida Etsushi, Furukawa Matakazu, Okada Munemasa, Ito Katsuyoshi
Department of Radiology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi, 755-8505, Japan.
Department of Radiology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi, 755-8505, Japan.
Eur J Radiol. 2021 Aug;141:109775. doi: 10.1016/j.ejrad.2021.109775. Epub 2021 May 12.
To investigate the clinical value of measuring the ECV fraction of the pancreas by DECT in association with an impaired glucose tolerance (IGT) estimated by the hemoglobin A1C (HbA1C) value in patients with or without cirrhosis.
This retrospective study included patients who underwent contrast-enhanced dynamic CT with dual-energy mode between March 2018 and February 2019. The ECV fraction of the pancreas was calculated from iodine map images created from equilibrium-phase contrast-enhanced DECT images. The cross-sectional areas of the pancreas were also measured.
In total, 51 patients were analyzed (median age, 69 years old; 22 women). The ECV fraction of the pancreas showed a significant negative correlation with the HbA1c value in the cirrhotic group (ρ=-0.346, p = 0.048), while there was no significant correlation in the non-cirrhotic group (ρ=-0.086, p = 0.734). In the elevated HbA1C group, the ECV fraction of the pancreas in the cirrhotic patients (median, 0.247; interquartile range [IQR], 0.098) was significantly lower than that in the non-cirrhotic patients (0.332, IQR 0.113) (p = 0.024). In the elevated HbA1C group, the cross-sectional area of the pancreas was significantly larger in the cirrhotic patients than that in the non-cirrhotic patients (median [IQR]; 2945 [904] vs. 1885 [909] mm, p = 0.019).
A reduction in the ECV fraction of the pancreas measured by DECT as well as the enlargement of the pancreatic parenchyma was observed in cirrhotic patients with IGT. These findings suggest that the measurement of the pancreatic ECV fraction by DECT may help clarify the pathophysiology of IGT in patients with cirrhosis.
探讨通过双能CT（DECT）测量胰腺细胞外液容积分数（ECV）在伴有或不伴有肝硬化患者中的临床价值，这些患者的糖耐量受损（IGT）通过糖化血红蛋白（HbA1C）值评估。
这项回顾性研究纳入了2018年3月至2019年2月期间接受双能模式对比增强动态CT检查的患者。胰腺的ECV分数由平衡期对比增强DECT图像生成的碘图计算得出。同时测量胰腺的横截面积。
共分析了51例患者（中位年龄69岁；22例女性）。肝硬化组中胰腺的ECV分数与HbA1c值呈显著负相关（ρ=-0.346，p = 0.048），而在非肝硬化组中无显著相关性（ρ=-0.086，p = 0.734）。在HbA1C升高组中，肝硬化患者胰腺的ECV分数（中位数为0.247；四分位数间距[IQR]为0.098）显著低于非肝硬化患者（0.332，IQR为0.113）（p = 0.024）。在HbA1C升高组中，肝硬化患者胰腺的横截面积显著大于非肝硬化患者（中位数[IQR]；2945[904] vs. 1885[909]mm，p = 0.019）。
在伴有IGT的肝硬化患者中观察到通过DECT测量的胰腺ECV分数降低以及胰腺实质增大。这些发现表明，通过DECT测量胰腺ECV分数可能有助于阐明肝硬化患者IGT的病理生理学机制。
