Zhang Hong, Hao Ee, Xia Dongqin, Ma Mingyue, Wu Jiayu, Liu Tongchi, Gao Ming, Wu Xiaoping
Department of Radiology, Affiliated Xi'an Central Hospital of Xi'an Jiaotong University, No. 161, Xiwu Road, Xincheng District, Xi'an, 710003, Shaanxi, China.
Department of Sixth Outpatient, Xijing 986 Hospital, Xi'an, 710054, China.
Sci Rep. 2025 May 26;15(1):18343. doi: 10.1038/s41598-025-03717-x.
To investigate the diagnostic value of spectral CT in calculating extracellular volume fraction (ECV) for assessing the severity of liver cirrhosis. This retrospective study enrolled 172 participants, including 127 patients diagnosed with liver cirrhosis and 45 matched controls, all of whom underwent spectral CT hepatic enhancement imaging. Disease severity stratification was performed using the Child-Pugh classification system. ECV values were derived from the iodine density map during the delayed phase. These ECV values were then compared across the control group and subclassified cirrhosis groups (Child-Pugh classes A-C). Furthermore, a correlation analysis was performed to assess the relationship between ECV values and Child-Pugh scores in liver cirrhosis. Receiver operating characteristic (ROC) curves were constructed to evaluate the diagnostic performance of ECV values and MELD-Na in the Child-Pugh classification of liver cirrhosis. The ECV values were 25.49 ± 3.15, 29.73 ± 3.20, 35.64 ± 3.15, and 45.30 ± 5.16 for the control, Child-Pugh A, Child-Pugh B, and Child-Pugh C group, respectively, demonstrating significant intergroup differences (F = 184.67 P < 0.001). A strong positive correlation was observed between ECV and Child-Pugh liver function classification (r = 0.791, P < 0.001). The diagnostic performance of ECV for differentiating between Child-Pugh classes A and B (AUC: 0.901), B and C (AUC: 0.966) was higher compared to the MELD-Na score (AUC: 0.772 and 0.868) (P < 0.05, respectively). Multivariate analyses showed that ECV was an independent factor for cirrhosis (OR 1.610, P < 0.001). ECV values measured using spectral CT can serve as a noninvasive biomarker for assessing the severity of liver cirrhosis.
探讨光谱CT测量细胞外容积分数（ECV）在评估肝硬化严重程度中的诊断价值。本回顾性研究纳入了172名参与者，其中包括127例确诊为肝硬化的患者和45名匹配的对照者，所有参与者均接受了光谱CT肝脏增强成像检查。采用Child-Pugh分类系统进行疾病严重程度分层。ECV值来自延迟期的碘密度图。然后将这些ECV值在对照组和肝硬化亚组（Child-Pugh A - C级）之间进行比较。此外，进行相关性分析以评估肝硬化患者中ECV值与Child-Pugh评分之间的关系。构建受试者操作特征（ROC）曲线以评估ECV值和终末期肝病模型钠（MELD-Na）评分在肝硬化Child-Pugh分类中的诊断性能。对照组、Child-Pugh A级、Child-Pugh B级和Child-Pugh C级组的ECV值分别为25.49±3.15、29.73±3.20、35.64±3.15和45.30±5.16，组间差异有统计学意义（F = 184.67，P < 0.001）。ECV与Child-Pugh肝功能分级之间存在强正相关（r = 0.791，P < 0.001）。与MELD-Na评分（AUC：0.772和0.868）相比，ECV区分Child-Pugh A级和B级（AUC：0.901）、B级和C级（AUC：0.966）的诊断性能更高（P均< 0.05）。多因素分析显示ECV是肝硬化的独立因素（OR 1.610，P < 0.001）。光谱CT测量的ECV值可作为评估肝硬化严重程度的非侵入性生物标志物。
