双层探测器光谱CT定量增强参数评估肝功能储备OA
Quantitative Enhancement Parameters of Dual-Layer Detector Spectral CT in the Assessment of Hepatic Functional Reserve
目的 探讨双层探测器光谱CT门脉期碘浓度(IC)和细胞外容积(ECV)定量参数对肝功能储备的评估价值.方法 回顾性纳入2020 年1 月至2022 年8 月行腹部光谱 CT 三期增强检查的24 例患者,基于门脉期能谱基数据生成 IC 及ECV图,测量肝左叶、右叶及尾状叶的IC与ECV 值.通过 Kruskal-Wallis 检验比较各肝叶参数差异,采用 Pearson/Spearman法分析IC及ECV与吲哚菁绿(ICG)清除试验参数之间的相关性.分析的关键参数包括:ICG 5 min 滞留率(ICGR5)、ICG 10 min滞留率(ICGR10)、ICG15 min滞留率(ICGR15)及ICG血浆清除率(ICG-CR),并基于相关性分析结果进一步构建多元线性回归模型.结果 肝右叶ECV与ICGR5(r=-0.48,P=0.019)、ICGR10(r=-0.48,P=0.019)、ICGR15(r=-0.47,P=0.021)均呈显著负相关,与 ICG-CR呈显著正相关(r=0.48,P=0.019).肝右叶 IC 与 ICGR5(r=-0.52,P=0.009)、ICGR10(r=-0.52,P=0.009)、ICGR15(r=-0.53,P=0.008)均呈显著负相关,与 ICG-CR 呈显著正相关(r=0.52,P=0.009).肝右叶IC对ICGR5(y=0.62-0.16×IC,R2=0.26,P=0.011)及 ICG-CR(y=0.09-0.07×IC,R2=0.32,P=0.004)的预测效能最佳,而 ECV未通过多元回归筛选.结论 双层探测器光谱 CT 门脉期肝右叶 IC值可作为评估肝功能储备的潜在影像标志物,其与 ICG清除试验的强相关性为无创肝功能定量评估提供了新思路.
Objective To evaluate the value of dual-layer spectral CT-derived iodine concentration(IC)and extracellular volume(ECV)in the portal venous phase in assessing hepatic functional reserve.Methods A total of 24 patients who underwent triphasic abdominal spectral CT enhancement scanning between January 2020 and August 2022 were retrospectively enrolled.IC and ECV maps were generated from spectral base data of the portal venous phase,and IC and ECV values were measured in the left lobe,right lobe,and caudate lobe of the liver.Differences in parameters among hepatic lobes were compared by the Kruskal-Wallis test.Pearson or Spearman correlation analysis was performed to assess the relationships of IC and ECV with parameters of the indocyanine green(ICG)clearance test.The key parameters analyzed included the ICG retention rates at 5 min(ICGR5),at 10 min(ICGR10),at 15 min(ICGR15),and the ICG clearance rate(ICG-CR).On the basis of correlation results,multivariate linear regression models were constructed.Results ECV in the right hepatic lobe showed neg-ative correlations with ICGR5(r=-0.48,P=0.019),ICGR10(r=-0.48,P=0.019),and ICGR15(r=-0.47,P=0.021)and a positive correlation with ICG-CR(r=0.48,P=0.019).IC in the right hepatic lobe also showed negative correlations with ICGR5(r=-0.52,P=0.009),ICGR10(r=-0.52,P=0.009),and ICGR15(r=-0.53,P=0.008)and a positive correlation with ICG-CR(r=0.52,P=0.009).IC in the right hepatic lobe demonstrated the best predictive performance for ICGR5(y=0.62-0.16×IC,R2=0.26,P=0.011)and ICG-CR(y=0.09-0.07×IC,R2=0.32,P=0.004),whereas ECV was not selected in the multivariate regression model.Conclusion The dual-layer spectral CT-derived IC in the portal venous phase of the right hepatic lobe demonstrates significant clinical relevance with hepatic functional reserve,potentially ser-ving as a non-invasive imaging biomarker for liver function assessment.
刘梦琦;田亚忠;陈志晔
中国人民解放军总医院海南医院放射诊断科,海南 三亚 572013中国人民解放军总医院海南医院放射诊断科,海南 三亚 572013中国人民解放军总医院海南医院放射诊断科,海南 三亚 572013
医药卫生
肝功能储备光谱CT碘浓度细胞外容积吲哚菁绿清除试验
hepatic functional reservespectral CTiodine concentrationextracellular volumeindocy-anine green clearance test
《中国医学科学院学报》 2026 (2)
238-243,6
国家重点研发计划(2023YFF1204104)
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