Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI, USA.
Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA.
J Cachexia Sarcopenia Muscle. 2022 Dec;13(6):2807-2819. doi: 10.1002/jcsm.13068. Epub 2022 Sep 5.
Computed tomography (CT) is a valuable assessment method for muscle pathologies such as sarcopenia, cachexia, and myosteatosis. However, several key underappreciated scan imaging parameters need consideration for both research and clinical use, specifically CT kilovoltage and the use of contrast material. We conducted a scoping review to assess these effects on CT muscle measures. We reviewed articles from PubMed, Scopus, and Web of Science from 1970 to 2020 on the effect of intravenous contrast material and variation in CT kilovoltage on muscle mass and density. We identified 971 articles on contrast and 277 articles on kilovoltage. The number of articles that met inclusion criteria for contrast and kilovoltage was 11 and 7, respectively. Ten studies evaluated the effect of contrast on muscle density of which nine found that contrast significantly increases CT muscle density (arterial phase 6-23% increase, venous phase 19-57% increase, and delayed phase 23-43% increase). Seven out of 10 studies evaluating the effect of contrast on muscle area found significant increases in area due to contrast (≤2.58%). Six studies evaluating kilovoltage on muscle density found that lower kilovoltage resulted in a higher muscle density (14-40% increase). One study reported a significant decrease in muscle area when reducing kilovoltage (2.9%). The use of contrast and kilovoltage variations can have dramatic effects on skeletal muscle analysis and should be considered and reported in CT muscle analysis research. These significant factors in CT skeletal muscle analysis can alter clinical and research outcomes and are therefore a barrier to clinical application unless better appreciated.
计算机断层扫描（CT）是一种评估肌肉疾病（如肌肉减少症、恶病质和肌内脂肪增多症）的有价值的方法。然而，对于研究和临床应用，有几个关键的被低估的扫描成像参数需要考虑，特别是 CT 千伏和对比材料的使用。我们进行了范围综述，以评估这些因素对 CT 肌肉测量的影响。我们检索了 1970 年至 2020 年期间 PubMed、Scopus 和 Web of Science 上关于静脉对比剂和 CT 千伏变化对肌肉质量和密度影响的文章。我们确定了 971 篇关于对比剂的文章和 277 篇关于千伏的文章。符合对比剂和千伏纳入标准的文章数量分别为 11 篇和 7 篇。有 10 项研究评估了对比剂对肌肉密度的影响，其中 9 项研究发现对比剂显著增加了 CT 肌肉密度（动脉期增加 6-23%，静脉期增加 19-57%，延迟期增加 23-43%）。评估对比剂对肌肉面积影响的 10 项研究中的 7 项发现，由于对比剂，肌肉面积显著增加（≤2.58%）。评估肌肉密度的 6 项千伏研究发现，较低的千伏会导致肌肉密度更高（增加 14-40%）。一项研究报告称，降低千伏时肌肉面积显著减少（2.9%）。对比剂和千伏变化的使用会对骨骼肌分析产生显著影响，因此在 CT 肌肉分析研究中应考虑并报告这些因素。这些在 CT 骨骼肌分析中重要的因素会改变临床和研究结果，除非更好地理解这些因素，否则会成为临床应用的障碍。
