Yu Lu, Song Zhengping, Li Zhoulei, Lv Wen, Yang Fei, Li Xuehua, Sun Canhui
Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, No. 58, Second Zhongshan Road, Yuexiu District, Guangzhou, 510080, People's Republic of China.
Department of Radiology, The First Affiliated Hospital, Jinan University, Guangzhou, 510632, People's Republic of China.
BMC Med Imaging. 2025 Jul 1;25(1):254. doi: 10.1186/s12880-025-01768-0.
To explore the feasibility and clinical significance of assessing liver function damage in patients with post-hepatitis cirrhosis using spectral CT by measuring the iodine density difference and CT value difference between the portal vein and hepatic vein.
A study was conducted involving 65 patients with post-hepatitis cirrhosis (30 with Child-Pugh grade A, 28 with grade B, and 7 with grade C) and 82 healthy controls. All underwent dual-phase enhanced spectral CT scans of the upper abdomen. Post-processing with IntelliSpace Portal software yielded iodine density (ID), 45 keV virtual monoenergetic (VMI), and conventional CT (HU) images. The mean iodine densities of the portal vein (ID) and hepatic vein (ID) were measured, and the difference in ID (ID), VMI (VMI), and HU (HU) between the portal vein and hepatic vein was calculated. These values were compared between the control group and different Child-Pugh grades of cirrhosis, as well as between the compensated cirrhosis group (Child-Pugh grade A) and the decompensated cirrhosis group (grade B/C). The ability to diagnose decompensated cirrhosis was evaluated by plotting ROC curves.
The ID, VMI, and HU were significantly higher in the cirrhosis group compared to the control group and were also higher in the grade B/C group compared to the grade A group (all p<0.05). Among all patients with cirrhosis, the AUROC values for diagnosing grade B/C using ID, VMI, HU, NID, NVMI , and NHU were 0.774, 0.798, 0.736, 0.775, 0.774, and 0.757, respectively (all p < 0.05).
The iodine density difference (ID) and CT value difference (VMI and HU ) between the portal vein and hepatic vein, as measured by spectral CT, demonstrate a significant positive correlation with the Child-Pugh classification of liver function in cirrhotic patients. These quantitative parameters provide a simple and non-invasive approach for assessing liver function in cirrhotic patients.
Not applicable.
通过测量门静脉与肝静脉之间的碘密度差值及CT值差值，探讨采用光谱CT评估肝炎后肝硬化患者肝功能损害的可行性及临床意义。
对65例肝炎后肝硬化患者（Child-Pugh A级30例、B级28例、C级7例）及82例健康对照者进行研究。所有受试者均接受上腹部双期增强光谱CT扫描。使用IntelliSpace Portal软件进行后处理，生成碘密度（ID）、45 keV虚拟单能量（VMI）及传统CT（HU）图像。测量门静脉（ID）和肝静脉（ID）的平均碘密度，并计算门静脉与肝静脉之间的ID差值（ΔID）、VMI差值（ΔVMI）及HU差值（ΔHU）。比较对照组与不同Child-Pugh分级肝硬化组之间以及代偿期肝硬化组（Child-Pugh A级）与失代偿期肝硬化组（B/C级）之间的这些值。通过绘制ROC曲线评估诊断失代偿期肝硬化的能力。
肝硬化组的ID、VMI及HU均显著高于对照组，且B/C级组高于A级组（均p<0.05）。在所有肝硬化患者中，使用ID、VMI、HU、ΔID、ΔVMI及ΔHU诊断B/C级的曲线下面积（AUROC）值分别为0.774、0.798、0.736、0.775、0.774及0.757（均p<0.05）。
光谱CT测量的门静脉与肝静脉之间的碘密度差值（ΔID）及CT值差值（ΔVMI和ΔHU）与肝硬化患者肝功能的Child-Pugh分级呈显著正相关。这些定量参数为评估肝硬化患者肝功能提供了一种简单且无创的方法。
不适用。
