双能量CT平扫测量口服胺碘酮患者的肝脏碘浓度的可行性研究

Quantitative measurement of iodine concentration in the liver using dual-energy CT in patients with oral amiodarone:a feasibility study

目的探讨双能量CT(DECT)定量测量长期口服胺碘酮患者的肝脏碘浓度的可行性。方法前瞻性收集2017年1月至2019年5月嘉兴市第二医院口服胺碘酮12个月以上的27例患者的临床和腹部DECT资料作为试验组;收集2017年1月因疾病需行腹部CT检查且符合纳入排除标准的18例患者的DECT资料作为对照组。分别测量并统计分析试验组和对照组在140 kV、100 kV、虚拟平扫(VNC)图像上的CT值和肝脏、胰腺、脾脏的碘浓度值的差异。肝脏CT值与肝脏碘浓度之间的相关性采用Spearman相关分析。结果试验组的肝脏、胰腺、脾脏碘浓度分别为0.2(0.2,0.4)、0.1(0.1,0.2)、0.2(0.1,0.2)mg/ml,对照组的肝脏、胰腺、脾脏碘浓度分别为0.2(0.1,0.2)、0.1(0.1,0.2)、0.1(0.1,0.2)mg/ml,试验组的肝脏碘浓度明显高于对照组,差异有统计学意义(Z=-3.354,P<0.05),胰腺、脾脏碘浓度两组间差异无统计学意义(Z=-0.179、-1.590,P均>0.05)。试验组100 kV、140 kV、VNC图像肝脏CT值[(74±18)、(70±10)、(71±5)HU]均高于对照组[(60±6)、(59±6)、(62±6)HU],差异均具有统计学意义(t=3.310、4.205、5.241,P均<0.05)。试验组140 kV图像CT值与碘浓度呈正相关(r=0.410,P<0.05)。试验组中,不同肝脏碘浓度患者之间,口服胺碘酮的时间差异有统计学意义(P<0.05)。结论DECT平扫可以定量测量长期口服胺碘酮患者的肝脏碘浓度,为评估胺碘酮致肝损伤提供生物学指标。

Objective To explore the feasibility of dual-energy CT(DECT)in the evaluation of liver iodine concentration in patients on long-term oral amiodarone treatment(≥12 months).Methods Eighteen subjects undergoing abdominal dual-energy CT who met the criterion in January 2017 were collected as a control group.Twenty-seven patients who received oral amiodarone treatment for more than 12 months from January 2017 to May 2019 were enrolled as an experimental group.The difference of CT value and iodine concentration of liver,pancreas and spleen in 140 kV,100 kV and VNC images between experimental and control groups were measured and analyzed.The correlation between liver CT value and liver iodine concentration was analyzed by Spearman correlation.Results The concentrations of iodine in the liver,pancreas and spleen of the experimental group were 0.2(0.2,0.4),0.1(0.1,0.2)and 0.2(0.1,0.2)mg/ml,and those in the control group were 0.2(0.1,0.2),0.1(0.1,0.2)and 0.1(0.1,0.2)mg/ml.The difference in the concentration of iodine of the liver was statistically significant(Z=-3.354,P<0.05),however there was no significant difference in the concentration of pancreas and spleen between the two groups(Z=-0.179 and-1.590,P>0.05).The CT values of 100 kV,140 kV,VNC images in the experimental group[(74±18),(70±10)and(71±5)HU]were higher than those in the control group[(60±6),(59±6)and(62±6)HU],and the differences were statistically significant(t=3.310,4.205 and 5.241,P<0.05).There was a positive correlation between the CT value of 140 kV image and iodine concentration(r=0.410,P<0.05).In the experimental group,the time difference of taking amiodarone was statistically significant(P<0.05).Conclusions DECT can be used to quantitatively measure the liver iodine concentration of patients with long-term oral amiodarone,and provides some biological indicators for the assessment of amiodarone induced liver injury.