能量CT定量检查对新西兰兔脂肪肝的诊断价值分析

Diagnostic value of energy CT quantitative examination for fatty liver in New Zealand rabbits

目的探讨能量CT定量检查对新西兰兔脂肪肝的诊断价值。方法选择39只新西兰兔中的30只作为实验组,9只作为对照组。实验组新西兰兔给予高脂饲料喂养,对照组给予普通饲料喂养。使用双源双能量128层CT对新西兰兔进行单能量及双能量扫描,实验组与对照组分别在喂养12、16、20周时分别取两组新西兰兔检测血清丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、甘油三酯、总胆固醇水平,完成抽血及CT扫描后进行HE染色病理检查。分析实验动物的脂肪肝成模结果、病理检查结果、肝脏脂肪含量及血清ALT、甘油三酯、AST、总胆固醇水平,对比不同程度脂肪肝在单能量、双能量CT扫描下不同管电压扫描下的CT值,分析单能量、双能量CT扫描下CT值与脂肪含量及血清ALT、AST、甘油三酯、总胆固醇的相关性。结果30只实验新西兰兔中,25只成模并顺利完成,成模率为83.33%,9只对照组均存活。病理检查结果,正常9只,轻度8只,中度8只,重度9只。轻度、中度、重度脂肪肝组的肝脏脂肪含量、血清ALT、AST、甘油三酯、总胆固醇水平明显较正常组高,中度、重度脂肪肝组明显较轻度脂肪肝组高,重度脂肪肝组明显较中度脂肪肝组高,差异均有统计学意义(P<0.05)。单能量CT扫描下,80、100、120、140 kV时,轻度、中度、重度脂肪肝组的CT值明显较正常组低,中度、重度脂肪肝组明显较轻度脂肪肝组低,重度脂肪肝组明显较中度脂肪肝组低,差异均有统计学意义(P<0.05)。双能量CT扫描下,40、60、80、100、120、140 kV时,轻度、中度、重度脂肪肝组的CT值明显较正常组低,中度、重度脂肪肝组明显较轻度脂肪肝组低,重度脂肪肝组明显较中度脂肪肝组低,差异均有统计学意义(P<0.05)。单能量CT扫描下,80、100、120、140 kV时的CT值与脂肪含量、血清ALT、AST、甘油三酯、总胆固醇均呈负相关(P<0.05)。双能量CT扫描下,40、60、80、100、120、140 kV时的CT值与脂肪含量、血清ALT、AST、甘油三酯、总胆固醇均呈负相关(P<0.05)。结论能量CT定量检查对新西兰兔脂肪肝的诊断效果较好,单能量CT扫描下100 kV CT值与脂肪含量及血清ALT、AST、甘油三酯、总胆固醇相关性最好。

Objective To investigate the diagnostic value of energy CT quantitative examination for fatty liver in New Zealand rabbits.Methods Thirty New Zealand rabbits were selected as the experimental group and 9 as the control group.New Zealand rabbits in experimental group were fed with high fat diet,while those in control group were fed with ordinary diet.Single-energy and dual-energy 128-slice CT were used to scan New Zealand rabbits.Serum levels of alanine transaminase(ALT),aspartic transaminase(AST),triglyceride and total cholesterol were detected in the experimental group and the control group at 12,16 and 20 weeks of feeding,respectively.HE staining was performed after blood drawing and CT scanning.The results of fatty liver modeling,pathological examination,liver fat content and serum levels of ALT,AST,triglyceride and total cholesterol were analyzed.The CT values of different degrees of fatty liver under different tube voltages and single-energy and dual-energy CT scans were compared.The correlation between CT value and fat content and serum ALT,AST,triglyceride and total cholesterol under single energy and dual energy CT scanning was analyzed.Results Thirty New Zealand rabbits in the experiment,25 rabbits were moulded and successfully completed,with a moulding rate of 83.33%.All 9 rabbits in the control group survived.The liver fat content,serum ALT,AST,triglyceride and total cholesterol levels in the mild,moderate and severe fatty liver groups were significantly higher than those in the normal group,the moderate and severe fatty liver groups were significantly higher than those in the mild fatty liver group,and the severe fatty liver group was significantly higher than those in the moderate fatty liver group,the differences were statistically significant(P<0.05).Under single-energy CT scanning,at 80,100,120 and 140 kV,the CT values of the mild,moderate and severe fatty liver groups were significantly lower than those of the normal group,the moderate and severe fatty liver groups were significantly lower than those of the mild fatty liver group,and the severe fatty liver group was significantly lower than that of the moderate fatty liver group,the differences were statistically significant(P<0.05).Under dual-energy CT scanning,at 40,60,80,100,120 and 140 kV,the CT values of the mild,moderate and severe fatty liver groups were significantly lower than those of the normal group,the moderate and severe fatty liver groups were significantly lower than those of the mild fatty liver group,and the severe fatty liver group was significantly lower than that of the moderate fatty liver group,the differences were statistically significant(P<0.05).Under single energy CT scan,the CT value at 80,100,120 and 140 kV was negatively correlated with fat content,serum ALT,AST,triglyceride and total cholesterol(P<0.05).Under dual-energy CT scanning,CT values at 40,60,80,100,120 and 140 kV were negatively correlated with fat content,serum ALT,AST,triglyceride and total cholesterol(P<0.05).Conclusion Energy CT quantitative examination has a good diagnostic effect on fatty liver in New Zealand rabbits.The 100 kV CT value under single energy CT scan has the best correlation with fat content and serum ALT,AST,triglyceride and total cholesterol.