双能量CT测量胰腺细胞外体积分数及标准化碘浓度评估2型糖尿病

Pancreatic extracellular volume fraction and normalized iodine concentration measured with dual-energy CT for evaluating type 2 diabetes mellitus

目的观察双能量CT测量胰腺细胞外体积分数(fECV)及标准化碘浓度(nIC)评估2型糖尿病(T2DM)的价值。方法根据T2DM诊断标准将76例接受腹部双能量CT三期增强扫描患者分为糖尿病组(n=34)和非糖尿病组(n=42),于平衡期碘基图测量胰腺fECV和nIC;对比组间差异,分析胰腺fECV、nIC与糖化血红蛋白(HbA1c)的相关性,评估其诊断T2DM的价值。结果糖尿病组HbA1c、胰腺fECV及nIC均明显高于非糖尿病组(P均<0.001)。胰腺fECV(r_(s)=0.593、0.397)及nIC(r_(s)=0.479、0.424)在全部76例患者及糖尿病组34例患者中均与HbA1c呈中等或弱正相关(P均<0.05)。胰腺fECV与nIC联合诊断T2DM的敏感度、特异度及曲线下面积(AUC)分别为76.50%、83.30%及0.824[95%CI(0.728,0.919)],其AUC明显高于单一nIC(Z=2.002,P=0.045)而与单一fECV无明显差异(Z=1.158,P=0.247)。结论双能量CT所测胰腺fECV及nIC均与HbA1c有一定相关性,有助于诊断T2DM。

Objective To observe the value of pancreatic extracellular volume fraction(fECV)and normalized iodine concentration(nIC)measured with dual-energy CT for evaluating type 2 diabetes mellitus(T2DM).Methods A total of 76 patients with abdominal diseases who underwent abdominal dual energy CT three-phase enhancement scan were enrolled and divided into diabetes group(n=34)and non diabetes group(n=42)according to T2DM diagnostic criteria.Pancreatic fECV and nIC were measured based on iodine maps at equilibrium phase.The indexes were compared between groups,the correlations of pancreatic fECV,nIC and hemoglobin A1c(HbA1c)were analyzed,and the value of pancreatic fECV and nIC for diagnosing T2DM was evaluated.Results HbA1c,pancreatic fECV and nIC of diabetes group were significantly higher than those of non diabetes group(all P<0.001).Among all 76 patients and 34 cases in diabetes group,pancreatic fECV(r_(s)=0.593,0.397)and nIC(r_(s)=0.479,0.424)were moderately or weakly positively correlated with HbA1c(all P<0.05).The sensitivity,specificity and area under the curve(AUC)of pancreatic fECV combining with nIC for diagnosing T2DM was 76.50%,83.30%and 0.824(95%CI[0.728,0.919]),and the AUC was higher than that of single nIC(Z=2.002,P=0.045)but no significant different with that of single fECV(Z=1.158,P=0.247).Conclusion Pancreatic fECV and nIC measured with dual-energy CT had certain correlation with HbA1c,hence being helpful for diagnosing T2DM.