Mahmoudi Scherwin, Martin Simon, Koch Vitali, Gruenewald Leon David, Bernatz Simon, D'Angelo Tommaso, Vogl Thomas J, Booz Christian, Yel Ibrahim
Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60590 Frankfurt, Germany.
Department of Biomedical Sciences and Morphological and Functional Imaging, University Hospital Messina, 98100 Messina, Italy.
Diagnostics (Basel). 2022 Oct 27;12(11):2601. doi: 10.3390/diagnostics12112601.
Background: This study investigates the correlation and discriminative diagnostic accuracy of dual-energy CT (DECT)-derived imaging biomarkers in patients with acute pancreatitis of varying severity. Methods: In this retrospective study, we included 51 patients with acute pancreatitis who had undergone portal-venous phase DECT of the abdomen. Three blinded readers independently performed region-of-interest measurements on DECT images in the inflammatory pancreatic parenchyma. The correlation between modified CT severity index (CTSI) and quantitative imaging parameters was investigated using Pearson correlation coefficient. We performed receiver operator curve (ROC) analysis to assess diagnostic accuracy of the quantitative image parameters for the differentiation between mild/moderate versus severe acute pancreatitis. The optimal discriminative cut-off value to diagnose severe acute pancreatitis was determined using the Youden index. Results: Moderate correlations were found between CTSI scores and iodine density (Pearson’s correlation coefficient r = −0.65; p < 0.001), as well as attenuation (r = −0.55; p < 0.001) and normalized iodine uptake (r = −0.50; p < 0.001). ROC curve analysis revealed highest ability to differentiate mild/moderate from severe acute pancreatitis for iodine density (AUC = 0.86, 95% confidence interval 0.75 to 0.97). An optimal iodine density threshold of ≤1.63 mg/mL was found to indicate severe acute pancreatitis with a sensitivity of 81.3% and specificity of 77.1%. Conclusion: DECT-derived iodine density correlates with acute pancreatitis severity and may facilitate prediction of severe acute pancreatitis.
本研究调查了双能CT（DECT）衍生的成像生物标志物在不同严重程度急性胰腺炎患者中的相关性及鉴别诊断准确性。方法：在这项回顾性研究中，我们纳入了51例接受腹部门静脉期DECT检查的急性胰腺炎患者。三名盲法阅片者独立在DECT图像上对炎性胰腺实质进行感兴趣区测量。使用Pearson相关系数研究改良CT严重指数（CTSI）与定量成像参数之间的相关性。我们进行了受试者操作特征曲线（ROC）分析，以评估定量图像参数对区分轻度/中度与重度急性胰腺炎的诊断准确性。使用约登指数确定诊断重度急性胰腺炎的最佳鉴别临界值。结果：CTSI评分与碘密度（Pearson相关系数r = -0.65；p < 0.001）、衰减（r = -0.55；p < 0.001）和标准化碘摄取（r = -0.50；p < 0.001）之间存在中度相关性。ROC曲线分析显示，碘密度区分轻度/中度与重度急性胰腺炎的能力最强（AUC = 0.86，95%置信区间0.75至0.97）。发现最佳碘密度阈值≤1.63 mg/mL可提示重度急性胰腺炎，敏感性为81.3%，特异性为77.1%。结论：DECT衍生的碘密度与急性胰腺炎严重程度相关，可能有助于预测重度急性胰腺炎。
