双源CT双能量真实平扫和虚拟平扫在脂肪肝诊断中的应用价值

The application value of dual source CT double energy TNC and VNC in the diagnosis of fatty liver

目的:探讨双源CT双能量真实平扫(TNC)和虚拟平扫(VNC)在脂肪肝诊断中的应用价值。方法:选取在医院就诊的187例脂肪肝患者,均行双源CT双能量增强扫描,比较TNC与VNC图像肝脏感兴趣区域(ROI)噪声、脾脏CT值、下腔静脉CT值等参数的差异,其中35例患者接受病理活检。结果:TNC图像肝脏ROI噪声、脾脏CT值、下腔静脉CT值分别为(7.55±0.64)、(56.14±4.84)HU和(50.22±4.14)HU,明显低于VNC图像,差异有统计学意义(t=15.473,t=6.483,t=12.434;P<0.05),而ROI信噪比、肝脏CT/脾脏CT、肝脏CT/下腔静脉CT分别为(5.81±1.03)、(0.77±0.31)和(0.88±0.30),明显低于VNC图像,差异有统计学意义(t=-10.573,t=-2.518,t=-4.365;P<0.05);TNC和VNC图像判断脂肪肝程度与病理结果Kappa值分别为0.746和0.359,差异有统计学意义(t=0.746,t=0.359;P<0.05),其中TNC图像判断脂肪肝程度准确率为91.43%,明显高于VNC图像的71.43%,差异有统计学意义(x2=4.629,P<0.05);TNC辐射剂量为(6.10±0.52)m Sv,明显高于VNC,差异有统计学意义(t=42.492,P<0.05)。结论:双源CT双能量TNC在脂肪肝诊断中应用价值高于VNC,值得临床使用。

Objective: To explore the application value of dual-source CT dual-energy true non-contrast-enhanced (TNC) and virtual non-contrast-enhanced (VNC) in the diagnosis of fatty liver. Methods: 187 patients with fatty liver were selected. And all of them underwent dual-source CT dual-energy enhancement scan. The differences of series of parameters included the noise of liver region of interest (ROI), CT value of spleen and CT value of inferior vena cava between TNC and VNC images were compared. Thirty-five patients of them underwent pathological biopsy. Results: The noise of liver ROI, CT value of spleen and CT value of inferior vena cava in TNC images were (7.55±0.64),(56.14±4.84) HU and (50.22±4.14) HU respectively, which were significantly lower than those in VNC images (t=15.473, t=6.483, t=12.434, P<0.05), while the signal-to-noise ratio of ROI, the radio of liver CT and spleen CT, the radio of liver CT and inferior vena cava CT were (5.81±1.03),(0.77±0.31) and (0.88±0.30) respectively, which were significantly lower than those of VNC images (t=-10.573, t=-2.518, t=-4.365, P<0.05). The Kappa values of TNC images and pathology result, and VNC images and pathology result in judging the degree of fatty liver were 0.746 and 0.359, respectively, and the differences of them were significant (t=0.746, t=0.359, P<0.05). The accuracy of TNC images in judging the degree of fatty liver was 91.43%, which was significantly higher than that of VNC images (71.43%)(x^2=4.629, P<0.05). And the radiation dose of TNC (6.10+0.52 mSv) were significantly higher than that of VNC (t=42.492, P<0.05). Conclusion: Dual-source CT dual-energy TNC is more valuable than VNC in the diagnosis of fatty liver and it is worthy in clinical use.