CT肝脾衰减比在非酒精性脂肪性肝病和动脉粥样硬化斑块患者中的诊断价值

Diagnostic value of CT liver-to-spleen attenuation ratio in patients with non-alcoholic fatty liver disease and atherosclerotic plaque.

作者信息

Han Dong, He Chongan, Gu Shuang, Zhang Dongxuan, Xu Liyun

机构信息

Dong Han Department of Medical Imaging, Beijing Changping Hospital of Chinese Medicine, Beijing 102200, P.R. China.

Chongan He Department of Medical Imaging, Beijing Changping Hospital of Chinese Medicine, Beijing 102200, P.R. China.

出版信息

Pak J Med Sci. 2024 Nov;40(10):2416-2421. doi: 10.12669/pjms.40.10.10578.

DOI:10.12669/pjms.40.10.10578

PMID:39554684

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11568714/

Abstract

OBJECTIVE

To explore the clinical value of computed tomography (CT) liver-to-spleen (L/S) attenuation ratio in patients with non-alcoholic fatty liver disease (NAFLD) accompanied by atherosclerotic plaque (AP).

METHODS

This was a single-center, retrospective, observational study of patients who were diagnosed with NAFLD undergoing CT scans at Beijing Changping Hospital of Chinese Medicine from April 2020 to April 2022. Patients were grouped according to whether they had a diagnosis of AP or not. Healthy individuals without NAFLD undergoing CT scans during the same period were also included as a control group. The patients were matched for gender, age, and BMI in a 1:1:1 ratio. Correlations between the CT L/S attenuation ratio, liver function indicators, and blood lipid levels were assessed in the three groups. The predictive value of the CT L/S attenuation ratio was evaluated using the receiver operating characteristic (ROC) curve and the area under the curve (AUC) analyses.

RESULTS

Eighty-nine cases in each group. The three groups had significant differences in liver function and blood lipid levels (<0.05). The CT L/S attenuation ratio in the NAFLD+AP and NAFLD groups was lower than that in the control group and was the lowest in the NAFLD+AP group (<0.05). There was no significant correlation between the CT L/S attenuation ratio and liver function indicators (>0.05), but it positively correlated with high-density lipoprotein (HDL) and negatively correlated with low-density lipoprotein (LDL), triglycerides (TG), and total cholesterol (TC) (<0.05). The CT L/S attenuation ratio had a high predictive value for NAFLD patients with AP (AUC=0.859).

CONCLUSIONS

The CT L/S attenuation ratio in NAFLD patients with AP is significantly reduced and is closely related to the levels of blood lipid indicators. The CT L/S attenuation ratio has a high predictive value for NAFLD patients with AP.

摘要

目的

探讨计算机断层扫描（CT）肝脏与脾脏（L/S）衰减比在非酒精性脂肪性肝病（NAFLD）合并动脉粥样硬化斑块（AP）患者中的临床价值。

方法

这是一项单中心、回顾性、观察性研究，研究对象为2020年4月至2022年4月在北京昌平中医医院接受CT扫描且被诊断为NAFLD的患者。根据患者是否诊断为AP进行分组。同期接受CT扫描且无NAFLD的健康个体也纳入作为对照组。患者按性别、年龄和体重指数以1:1:1的比例进行匹配。评估三组中CT L/S衰减比、肝功能指标和血脂水平之间的相关性。使用受试者操作特征（ROC）曲线和曲线下面积（AUC）分析评估CT L/S衰减比的预测价值。

结果

每组89例。三组在肝功能和血脂水平方面存在显著差异（<0.05）。NAFLD+AP组和NAFLD组的CT L/S衰减比低于对照组，且在NAFLD+AP组中最低（<0.05）。CT L/S衰减比与肝功能指标之间无显著相关性（>0.05），但与高密度脂蛋白（HDL）呈正相关，与低密度脂蛋白（LDL）、甘油三酯（TG）和总胆固醇（TC）呈负相关（<0.05）。CT L/S衰减比对合并AP的NAFLD患者具有较高的预测价值（AUC=0.859）。