胸部低剂量计算机断层扫描与常规剂量计算机断层扫描在评估贫血中的比较：一项中国筛查队列的初步研究。
Comparison between thoracic low-dose computed tomography and conventional-dose computed tomography in evaluating anemia: A preliminary study in a Chinese screening cohort.
作者信息
Zhang Jianing, Wu Minghao, Huang Jinchao, Li Shixia, Ye Zhaoxiang
机构信息
Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China.
Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
出版信息
Front Cardiovasc Med. 2022 Oct 26;9:987753. doi: 10.3389/fcvm.2022.987753. eCollection 2022.
PURPOSE
To investigate and evaluate the value of thoracic low dose computed tomography (LDCT) scan in the diagnosis of anemia.
MATERIALS AND METHODS
661 patients who received thoracic computed tomography (CT) examination and underwent a peripheral blood examination were retrospectively included. 341 patients underwent conventional dose CT (CDCT), and 320 patients underwent LDCT. Regions of interest (ROI) were placed on the left ventricular cavity (LV), descending aorta (DAo), and interventricular septum (IVS). The corresponding CT attenuation was measured, and the CT attenuation difference between LV and IVS (IVS-LV) and between DAo and IVS (IVS-DAo) was calculated, respectively. One-way analysis of variance (ANOVA) and linear regression were performed to analyze the relationship between these indicators and Hb levels. The receiver operating characteristic (ROC) curve was used to evaluate prediction performance.
RESULTS
Both attenuation on LDCT and CDCT showed significant differences between the healthy group and the anemic group ( < 0.05). In the LDCT group, the LV and DAo were more relevant with the hemoglobin (Hb) level (correlation coefficient 0.618 and 0.602) than other indicators, with AUCs of 0.815 (95% CI: 0.763-0.868) and 0.803 (95% CI: 0.747-0.859), respectively. The linear regression formulas for Hb level with the LV and DAo were 19.14 + 0.15 × HU [95% CI: (16.52, 21.75) + (0.12, 0.17) × HU] and 19.46 + 0.16 × HU [95% CI: (16.55, 22.36) + (0.13, 0.18) × HU], respectively. Youden's index indicated that 37.5 HU and 38.5 HU were the best thresholds to diagnose anemia for LV and DAo, respectively. In the CDCT group, the LV and IVS-LV got obviously higher correlation coefficients (0.813 and 0.812), with AUCs of 0.831 (95% CI: 0.786-0.877) and 0.851 (95% CI: 0.808-0.894), respectively. The optimal thresholds for LV and IVS-LV were 40.5 HU and 9.5 HU, respectively.
CONCLUSION
In LDCT examinations, an approximation of Hb level and detecting of anemia can be conducted based on simple attenuation measurements.
目的
探讨并评估胸部低剂量计算机断层扫描（LDCT）在贫血诊断中的价值。
材料与方法
回顾性纳入661例接受胸部计算机断层扫描（CT）检查并进行外周血检查的患者。341例患者接受常规剂量CT（CDCT）检查，320例患者接受LDCT检查。在左心室腔腔（LV）、降主动脉（DAo）和室间隔（IVS）上设置感兴趣区（ROI）。测量相应的CT衰减值，分别计算LV与IVS之间（IVS-LV）以及DAo与IVS之间（IVS-DAo）的CT衰减差异。采用单因素方差分析（ANOVA）和线性回归分析这些指标与血红蛋白（Hb）水平之间的关系。采用受试者操作特征（ROC）曲线评估预测性能。
结果
健康组与贫血组的LDCT和CDCT衰减值均存在显著差异（<0.05）。在LDCT组中，LV和DAo与血红蛋白（Hb）水平的相关性（相关系数分别为0.618和0.602）高于其他指标，AUC分别为0.815（95%CI：0.763-0.868）和0.803（95%CI：0.747-0.859）。Hb水平与LV和DAo的线性回归公式分别为19.14 + 0.15×HU [95%CI：(16.52, 21.75) + (0.12, 0.17)×HU]和19.46 + 0.16×HU [95%CI：(16.55, 22.36) + (0.13, 0.18)×HU]。约登指数表明，37.5 HU和38.5 HU分别是LV和DAo诊断贫血的最佳阈值。在CDCT组中，LV和IVS-LV的相关系数明显更高（分别为0.813和0.812），AUC分别为0.831（95%CI：0.786-0.877）和0.851（95%CI：0.808-0.894）。LV和IVS-LV的最佳阈值分别为40.5 HU和9.5 HU。
结论
在LDCT检查中，可基于简单的衰减测量来近似估计Hb水平并检测贫血。
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