双源CT双能量真实平扫与虚拟平扫对脂肪肝的诊断价值对比

摘要/Abstract

摘要： 目的探讨双源CT双能量真实平扫与虚拟平扫对脂肪肝的诊断价值差异。方法分析70例以双源CT腹部增强扫描的脂肪肝患者真实平扫图像与虚拟平扫图像。分析肝门层面上两图像上肝左右叶、脾、下腔静脉的CT值及噪声值,同时测量该平面腹部前后径与左右径,记录剂量长度乘积。评价各CT值与噪声差异,分析肝右叶噪声与上腹部各径线相关性。同时以肝/脾CT值比值<0.8以及肝/下腔静脉CT值比值<1.0为标准诊断中重度脂肪肝,并比较两图像上其诊断一致性。结果 :肝左叶(P=0.007)、肝右叶(P<0.001)与脾CT值(P<0.001)比较VNC图像结果显著高于TNC,噪声比较VNC图像上结果均小于TNC结果(P<0.001),肝右叶噪声与上腹部前后径(r=0.561)、左右径(r=0.605)、平均径(r=0.608)在TNC图像上均中等相关(P<0.001),VNC图像上为弱相关。以肝/脾CT值比值<0.8为重度脂肪肝诊断标准,TNC与VNC图像诊断一致性kappa值为0.595;以肝/下腔静脉CT值比值<1.0为诊断标准,其诊断一致性kappa值为0.484,DLP值在VNC替代TNC后可降低24.1%。结论 TNC与VNC在中重度脂肪肝的诊断上中等一致,肝/脾CT值比值<0.8这一标准更推荐。

关键词: 脂肪肝, 体层摄影术, 双源CT, 临床诊断

张跃. 双源CT双能量真实平扫与虚拟平扫对脂肪肝的诊断价值对比[J]. 肝脏, 2016, 21(8): 673-677.

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