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目的:探讨单源双能CT能谱成像的碘(水)浓度值评估脂肪肝和肝岛血供的价值。方法:搜集行能谱CT扫描且诊断为脂肪肝及肝岛的20例患者。由两位放射科医生分别测量同一患者脂肪肝背景和肝岛的平扫及三期增强扫描的混合能量CT值及碘(水)浓度值,计算混合能量CT值及碘(水)浓度值的三期增强率。使用Bland-Altman图、直线回归分析及组内相关系数(ICC)检验两位观察者所测数据的一致性。比较脂肪肝与肝岛平扫、三期增强扫描的混合能量CT值及碘(水)浓度值的差异,比较脂肪肝与肝岛混合能量CT值及碘(水)浓度值三期增强率的差异。结果:两位观察者所测数据的一致性很好(ICC>0.75)。平扫及三期增强扫描中,肝岛的混合能量CT值和碘(水)浓度值均高于脂肪肝背景(P值均<0.001);脂肪肝与肝岛的混合能量CT值三期增强率差异均有统计学意义(P=0.006、P<0.001、P<0.001);脂肪肝与肝岛的碘(水)浓度值三期增强率差异均无统计学意义(P=0.455、P=0.279、P=0.279)。结论:单源双能CT能谱成像碘(水)值增强率评估脂肪肝与肝岛血供更可靠,证实肝岛与脂肪肝血供状态一致,为临床上鉴别肝岛与不典型乏血供肝脏肿瘤提供了相关依据。
Objective: To investigate the value of iodine (water) concentration in single-source dual-energy CT imaging for evaluating the blood supply of fatty liver and liver island. Methods: Twenty patients were diagnosed as fatty liver and hepatic island by scanning CT scan. Two radiologists measured CT and iodine (water) and CT (mixed energy) and iodine (water) values of the same patient’s fatty liver and hepatic island in plain scan and triple enhanced scan respectively Three enhanced rate. Bland-Altman plots, linear regression analysis and intraclass correlation coefficient (ICC) were used to test the consistency of the data measured by the two observers. Comparing the difference of CT and iodine (water) concentration between steatofemoral and hepatic island plain scan and three-phase enhanced scan, compare the three-phase enhancement rate of mixed energy CT value and iodine (water) concentration between fatty liver and liver island difference. Results: The agreement between the two observers was good (ICC> 0.75). The CT and iodine (IOD) values of Hepato are higher than that of fatty liver (both P <0.001) in plain scan and triple enhanced scan. The CT value of mixed energy of fatty liver and hepatic island was increased in three stages (P = 0.006, P <0.001, P <0.001). There was no significant difference in the three-phase enhancement rates of iodine (water) between fatty liver and liver island (P = 0.455, P = 0.279, P = 0.279). CONCLUSION: The enhancement of iodine (water) value of single-source dual-energy CT imaging is more reliable in assessing the blood supply of fatty liver and liver island, which confirms that the status of liver island and fatty liver is consistent with blood supply. It is clinically useful to identify liver island and atypical hypocalcemia For liver tumors provide the relevant basis.