Faculty of Medicine and Health Sciences, Tampere University, Kauppi Campus, Arvo Ylpön katu 34, 33520 Tampere, Finland.
Faculty of Medicine and Health Sciences, Tampere University, Kauppi Campus, Arvo Ylpön katu 34, 33520 Tampere, Finland; Department of Radiology, Tampere University Hospital, Elämänaukio, Kuntokatu 2, 33520 Tampere, Finland.
Eur J Radiol. 2021 Dec;145:109943. doi: 10.1016/j.ejrad.2021.109943. Epub 2021 Aug 30.
We aim to review the methods, current research evidence, and future directions in body composition analysis (BCA) with CT imaging.
CT images can be used to evaluate muscle tissue, visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT) compartments. Manual and semiautomatic segmentation methods are still the gold standards. The segmentation of skeletal muscle tissue and VAT and SAT compartments is most often performed at the level of the 3rd lumbar vertebra. A decreased amount of CT-determined skeletal muscle mass is a marker of impaired survival in many patient populations, including patients with most types of cancer, some surgical patients, and those admitted to the intensive care unit (ICU). Patients with increased VAT are more susceptible to impaired survival / worse outcomes; however, those patients who are critically ill or admitted to the ICU or who will undergo surgery appear to be exceptions. The independent significance of SAT is less well established. Recently, the roles of the CT-determined decrease of muscle mass and increased VAT area and epicardial adipose tissue (EAT) volume have been shown to predict a more debilitating course of illness in patients suffering from severe acute respiratory syndrome coronavirus 2 (COVID-19) infection.
The field of CT-based body composition analysis is rapidly evolving and shows great potential for clinical implementation.
本文旨在综述 CT 成像在人体成分分析（BCA）中的方法、当前研究证据和未来方向。
CT 图像可用于评估肌肉组织、内脏脂肪组织（VAT）和皮下脂肪组织（SAT）区室。手动和半自动分割方法仍然是金标准。骨骼肌组织和 VAT 及 SAT 区室的分割通常在第 3 腰椎水平进行。CT 确定的骨骼肌量减少是许多患者群体（包括大多数类型癌症患者、某些手术患者和入住重症监护病房（ICU）的患者）生存受损的标志。VAT 增加的患者更容易出现生存受损/预后较差的情况；然而，那些危重症或入住 ICU 或将要接受手术的患者似乎是例外。SAT 的独立意义尚未得到充分证实。最近，CT 确定的肌肉质量减少以及 VAT 面积和心外膜脂肪组织（EAT）体积增加的作用已被证明可预测严重急性呼吸综合征冠状病毒 2（COVID-19）感染患者病情恶化。
基于 CT 的人体成分分析领域正在迅速发展，具有很大的临床应用潜力。
