定量CT技术在非酒精性脂肪肝定量诊断中的价值分析
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摘要
目的评价定量CT技术在非酒精性脂肪肝定量诊断中的临床价值。方法回顾性选取2014年3月～2018年6月于本院接受腹部CT检查的32例患者的临床资料,根据肝组织活检结果将患者分为轻度脂肪改变组(11例)、中度脂肪改变组(11例)和重度脂肪改变组(10例),另纳入20例无肝脂肪变性或脂肪变性相关临床表现者作为对照组,均于肝穿刺活检前1 d行肝脏CT平扫,测量肝脏、脾脏CT值,经测量及数据处理后,以病理结果为金标准,用CT阈值和肝内血管相对密度及肝/脾CT值比值对CT对肝细胞脂肪变性的诊断进行定量分析。结果 52例患者CT平扫诊断,不同程度脂肪肝组CT值和肝/脾CT值比值间均存在统计学差异(P<0.05),根据CT值阈值、血管相对密度值分级及肝/脾CT值比值标准,定量诊断正确率分别为76.9%、94.2%和98.1%。结论定量CT技术在非酒精性脂肪肝定量诊断中呈现出良好的准确性和优势,可用于非酒精性脂肪肝的诊断和治疗评估,值得在临床中推广应用。
Objective To evaluate the clinical value of quantitative CT in the quantitative diagnosis of nonalcoholic fatty liver. Methods The clinical data of 32 patients who underwent abdominal CT in our hospital from March 2014 to June 2018 were retrospectively selected. According to the results of liver biopsy, the patients were divided into mild fat changes group(11 cases) and moderate fat changes group(11 cases) and severe fat change group(10 cases). And 20 cases of non-hepatic steatosis or steatosis-related clinical manifestations were included as control group. Liver CT scan was performed on 1 day before liver biopsy. The liver and spleen CT values were measured. After measurement and data processing, the pathological results were used as the gold standard. The CT threshold and the relative density of intrahepatic vessels and the ratio of liver/spleen CT values were used to quantitatively analyze diagnosis of CT in hepatic steatosis. Results A total of 52 patients were diagnosed by CT scan. There were statistical differences in CT values and liver/spleen CT values between different degrees of fatty liver group(P<0.05). According to CT threshold, vascular relative density, and liver/spleen CT value ratio standard, the quantitative diagnosis accuracy rate were 76.9%, 94.2% and98.1%, respectively. Conclusion Quantitative CT technique has good accuracy and advantages in the quantitative diagnosis of nonalcoholic fatty liver. It can be used for the diagnosis and treatment evaluation of nonalcoholic fatty liver disease, and it is worthy of popularization in clinical practice.
Objective To evaluate the clinical value of quantitative CT in the quantitative diagnosis of nonalcoholic fatty liver. Methods The clinical data of 32 patients who underwent abdominal CT in our hospital from March 2014 to June 2018 were retrospectively selected. According to the results of liver biopsy, the patients were divided into mild fat changes group(11 cases) and moderate fat changes group(11 cases) and severe fat change group(10 cases). And 20 cases of non-hepatic steatosis or steatosis-related clinical manifestations were included as control group. Liver CT scan was performed on 1 day before liver biopsy. The liver and spleen CT values were measured. After measurement and data processing, the pathological results were used as the gold standard. The CT threshold and the relative density of intrahepatic vessels and the ratio of liver/spleen CT values were used to quantitatively analyze diagnosis of CT in hepatic steatosis. Results A total of 52 patients were diagnosed by CT scan. There were statistical differences in CT values and liver/spleen CT values between different degrees of fatty liver group(P<0.05). According to CT threshold, vascular relative density, and liver/spleen CT value ratio standard, the quantitative diagnosis accuracy rate were 76.9%, 94.2% and98.1%, respectively. Conclusion Quantitative CT technique has good accuracy and advantages in the quantitative diagnosis of nonalcoholic fatty liver. It can be used for the diagnosis and treatment evaluation of nonalcoholic fatty liver disease, and it is worthy of popularization in clinical practice.
引文
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[2]杜诗霖,徐凌燕,高鹏,等.定量CT技术定量诊断脂肪肝的临床应用探究[J].现代医用影像学,2017,26(2):330-331.
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[6]彭光旭,陈静,吴玉霞.肝内血管相对密度法联合肝脾CT值比值法在脂肪肝定量诊断中的应用[J].中国民族民间医药,2015,11(1):114-115.
[7]惠斌.CT在脂肪肝定量诊断中的应用价值分析[J].影像研究与医学应用,2017,1(11):131-132.
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[12]吴瑶媛,董江宁.能谱CT、MRI定性和定量诊断脂肪肝及研究进展[J].国际医学放射学杂志,2016,39(1):39-43.
[13]Gaglio PJ.Nonalcoholic fatty liver disease[J].Clinics in Liver Disease,2016,20(2):xiii-xiv.
[14]Chalasani N,Younossi Z,Lavine JE,et al.The diagnosis and management of nonalcoholic fatty liver disease:Practice guidance from the American Association for the Study of Liver Diseases[J].Hepatology,2017,55(6):2005-2023.
[15]曹邱婷,赵丽琴,杨正汉,等.单源双能能谱CT对大鼠脂肪肝定量分析的多参数研究[J].放射学实践,2017,32(5):475-478.
[16]Vajro P,Lenta S,Socha P,et al.Diagnosis of nonalcoholic fatty liver disease in children and adolescents:position paper of the ESPGHAN Hepatology Committee[J].Journal of Pediatric Gastroenterology&Nutrition,2016,54(5):700-713.
[17]王海宝.探讨脂肪肝CT定量诊断与患者肝功能的关系及对临床疗效评价的价值[J].世界最新医学信息文摘,2016,16(95):121-122.
[18]Lonardo A,Ballestri S,Marchesini G,et al.Nonalcoholic fatty liver disease:A precursor of the metabolic syndrome[J].Dig Liver Dis,2015,47(3):181-190.
[19]Nobili V,Alkhouri N,Alisi A,et al.Nonalcoholic Fatty liver disease:A challenge for pediatricians[J].Jama Pediatr,2015,169(2):170.
[20]周选民,刘玥,胡承雷,等.CT对大鼠脂肪肝定量诊断的实验研究[J].西部医学,2015,27(1):13-16.
[2]杜诗霖,徐凌燕,高鹏,等.定量CT技术定量诊断脂肪肝的临床应用探究[J].现代医用影像学,2017,26(2):330-331.
[3]Zheng X,Ren Y,Phillips WT,et al.Assessment of hepatic fatty infiltration using spectral computed tomography imaging:a pilot study[J].Journal of Computer Assisted Tomography,2013,37(2):134.
[4]El-Hassan AY,Ibrahim EM,Al-Mulhim FA,et al.Fatty infiltration of the liver:analysis of prevalence,radiological and clinical features and influence on patient management[J].Br J Radiol,2014,65(777):774-778.
[5]龚筑,段庆红,阮志兵,等.定量CT技术定量诊断脂肪肝的临床应用[J].实用放射学杂志,2016,32(6):950-954.
[6]彭光旭,陈静,吴玉霞.肝内血管相对密度法联合肝脾CT值比值法在脂肪肝定量诊断中的应用[J].中国民族民间医药,2015,11(1):114-115.
[7]惠斌.CT在脂肪肝定量诊断中的应用价值分析[J].影像研究与医学应用,2017,1(11):131-132.
[8]Chalasani N,Younossi Z,Lavine JE,et al.The diagnosis and management of nonalcoholic fatty liver disease:Practice guidance from the American Association for the Study of Liver Diseases[J].Hepatology,2017,55(6):2005-2023.
[9]刘建新,江永尧,朱映红,等.脂肪肝CT定量诊断与肝功能损伤的相关性研究及对临床疗效评价的价值[J].中外医学研究,2016,14(18):6-8.
[10]王东宁,陶杨.超声、CT、MRI诊断脂肪肝的准确性比较[J].现代医学,2015,43(7):851-854.
[11]Shiozawa K,Watanabe M,Ikehara T,et al.Evaluation of hemodynamics in focal steatosis and focal spared lesion of the liver using contrast-enhanced ultrasonography with sonazoid[J].Radiology Research&Practice,2014,2014(201):104-110.
[12]吴瑶媛,董江宁.能谱CT、MRI定性和定量诊断脂肪肝及研究进展[J].国际医学放射学杂志,2016,39(1):39-43.
[13]Gaglio PJ.Nonalcoholic fatty liver disease[J].Clinics in Liver Disease,2016,20(2):xiii-xiv.
[14]Chalasani N,Younossi Z,Lavine JE,et al.The diagnosis and management of nonalcoholic fatty liver disease:Practice guidance from the American Association for the Study of Liver Diseases[J].Hepatology,2017,55(6):2005-2023.
[15]曹邱婷,赵丽琴,杨正汉,等.单源双能能谱CT对大鼠脂肪肝定量分析的多参数研究[J].放射学实践,2017,32(5):475-478.
[16]Vajro P,Lenta S,Socha P,et al.Diagnosis of nonalcoholic fatty liver disease in children and adolescents:position paper of the ESPGHAN Hepatology Committee[J].Journal of Pediatric Gastroenterology&Nutrition,2016,54(5):700-713.
[17]王海宝.探讨脂肪肝CT定量诊断与患者肝功能的关系及对临床疗效评价的价值[J].世界最新医学信息文摘,2016,16(95):121-122.
[18]Lonardo A,Ballestri S,Marchesini G,et al.Nonalcoholic fatty liver disease:A precursor of the metabolic syndrome[J].Dig Liver Dis,2015,47(3):181-190.
[19]Nobili V,Alkhouri N,Alisi A,et al.Nonalcoholic Fatty liver disease:A challenge for pediatricians[J].Jama Pediatr,2015,169(2):170.
[20]周选民,刘玥,胡承雷,等.CT对大鼠脂肪肝定量诊断的实验研究[J].西部医学,2015,27(1):13-16.
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