基于身体指数测量计算肝脏CT增强扫描个体化碘对比剂方案的研究

Study on the Scheme of Calculating Individualized Iodine Contrast Agent for Enhanced CT Scan of Liver Based on Body Index Measurement

目的探究基于身体指数个体化计算肝脏CT增强扫描碘对比剂的可行性和相关性。方法选取2019年2月至2020年2月于我院接受肝脏CT增强扫描的患者136例。测量所有患者身高(HT)、全体重(TBW),计算去脂肪体重(LBW)、血容量(BV)、体重指数(BMI)、身体脂肪比例(BFP)、体表面积(BSA)。根据患者性别、TBW、BMI、BSA分为4个亚组,分别为男性组和女性组、TBW<65kg组和TBW≥65kg、BMI<25kg/m^(2)组和BMI≥25kg/m^(2)组、BSA<1.6m^(2)组和BSA≥1.6m^(2)组。比较不同亚组患者之间主动脉、肝脏增强的CT值,用ΔHU表示,并分析不同身体指数与主动脉、肝脏每克碘增强值之间的相关性。结果男性患者的HT、TBW、BV、LBW、BSA均高于女性患者,BFP低于女性患者(P<0.05);男性患者主动脉ΔHU值、肝脏ΔHU值均低于女性患者(P<0.05)。TBW<65kg的患者主动脉ΔHU值、肝脏ΔHU值均高于TBW≥65kg的患者(P<0.05)。BMI<25kg/m^(2)的患者肝脏ΔHU值高于BMI≥25kg/m^(2)的患者(P<0.05)。BSA<1.6m^(2)的患者主动脉ΔHU值、肝脏ΔHU值均高于BSA≥1.6m^(2)的患者(P<0.05);HT、TBW、BV、LBW、BSA与主动脉每克碘增强值均呈负相关(P<0.05),TBW、BV、BMI、LBW、BSA与肝脏每克碘增强值均呈负相关(P<0.05)。结论患者的身体指数对肝动脉期腹主动脉和门静脉期肝脏增强有不同程度的影响。LBW和BSA与主动脉和肝脏强化程度密切相关,根据患者身体指数LBW或BSA计算碘对比剂剂量能够缩小患者肝脏增强程度的差异。

Objective To explore the feasibility and relevance of calculating individualized iodine contrast agent based on body index for CT enhanced scan of liver.Methods Total of 136 patients who underwent enhanced CT scan of liver in our hospital from February 2019 to February 2020 were selected.Measure the height(HT),total body weight(TBW)of all patients,and calculate the lean body mass(LBW),blood volume(BV),body mass index(BMI),body fat ratio(BFP),body surface area(BSA).According to the patient's gender,TBW,BMI,BSA,it is divided into 4 subgroups,namely male group and female group,TBW<65kg group and TBW≥65kg,BMI<25kg/m^(2) group and BMI≥25kg/m^(2) group,BSA<1.6m^(2) group and BSA≥1.6m^(2) group.Compare the CT values of aortic and liver enhancement between different subgroups of patients,expressed asΔHU,analyze the correlation between different body indexes and the enhancement value of iodine per gram of aorta and liver.Results Male patients had higher HT,TBW,BV,LBW,and BSA than female patients,and BFP was lower than female patients(P<0.05).The aorticΔHU value and liverΔHU value of male patients were lower than female patients(P<0.05).Patients with TBW<65kg had higher aorticΔHU value and liverΔHU value than those with TBW≥65kg(P<0.05).Patients with BMI<25kg/m^(2) had higher liverΔHU value than patients with BMI≥25kg/m^(2)(P<0.05).Patients with BSA<1.6m^(2) had higher aorticΔHU value and liverΔHU value than those with BSA≥1.6m^(2)(P<0.05).HT,TBW,BV,LBW,BSA were negatively correlated with iodine enhancement value per gram of aorta(P<0.05),TBW,BV,BMI,LBW,BSA were negatively correlated with liver iodine enhancement value(P<0.05).Conclusion The body index of different patients has different degrees of influence on liver enhancement in the abdominal aorta in the hepatic artery phase and in the portal vein phase.LBW and BSA are closely related to the degree of aortic and liver enhancement.Calculating the dose of iodine contrast agent according to the patient's body index LBW or BSA can narrow the difference in the degree of liver enhancement.