能谱CT多物质解析评价继发性下肢淋巴水肿分级

郭佳; 信建峰; 张春燕; 过丽芳; 王梦君; 王仁贵; 董健

doi:10.15953/j.ctta.2022.004

能谱CT多物质解析评价继发性下肢淋巴水肿分级

首都医科大学附属北京世纪坛医院放射科, 北京100038

基金项目: 国家自然科学基金面上项目（基于多模态影像和遗传基因筛查对原发性淋巴水肿临床分期和分级精准评价的人工智能分析（61876216））；北京市医管局科研培育计划（多模态影像学淋巴管成像在下肢淋巴肿类疾病中的应用价值研究（PX2019027））。

详细信息

作者简介:
郭佳: 女，首都医科大学附属北京世纪坛医院住院医师，主要从事淋巴系统疾病的影像学诊断，E-mail：guojia@bjsjth.cn

董健: 男，首都医科大学附属北京世纪坛医院副主任医师，主要从事循环及淋巴系统疾病的影像学诊断，E-mail：dongjian3070@bjsjth.cn

中图分类号: R 814
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出版历程
- 收稿日期: 2022-01-06
- 录用日期: 2022-02-16
- 网络出版日期: 2022-03-03
- 发布日期: 2022-05-22

Spectral CT Multi-material Decomposition in Evaluation of Secondary Lower Extremity Lymphedema: A Prospective Study

Department of Radiology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China

摘要

摘要: 目的：探讨能谱CT多物质解析算法在继发性下肢淋巴水肿分级评价中的应用价值。材料及方法：前瞻性收集2019年6月至2020年6月因继发性下肢淋巴水肿入我院就诊并行能谱CT断层扫描的患者，由两名具有5年以上CT诊断经验的医师共同对能谱CT图像进行分析，采用阈值法测量患侧与健侧下肢体积，计算（患侧下肢体积 - 健侧下肢体积）/健侧下肢体积的百分比，根据2016版国际淋巴学会共识，将入组患者分为轻度、中度、重度；使用能谱CT多物质解析算法分别测量患侧与健侧下肢脂肪含量，得出脂肪体积分数，采用配对&lt;i&lt;t&lt;/i&lt;检验分别分析轻、中、重度患者患侧与健侧下肢脂肪体积分数之间的差异；采用秩和检验分别分析轻、中、重度患者两两之间患侧下肢脂肪体积分数的差异。结果：最终入组患者 40例，女/男（36/4），年龄范围32～71岁，中位年龄（53±10）岁，病程（3±5）年，轻度8例，中度14例，重度18例。轻、中、重度患者的患侧与健侧下肢脂肪体积分数之间差异均有统计学意义；轻、中、重度患者两两之间患侧下肢脂肪体积分数差异无统计学意义。结论：能谱CT多物质解析算法可以量化继发性下肢淋巴水肿的脂肪含量比，但不能单独用于下肢病变的分级评价中。
- 能谱CT /
- 多物质解析 /
- 下肢淋巴水肿 /
- 分级
Abstract: Objective: To explore the application value of spectral CT multi-material decomposition (MMD) algorithm in the grading of secondary lower extremity Lymphedema. Materials and methods: Prospective collection of patients who underwent spectral CT admitted to our hospital from June 2019 to June 2020 were prospectively collected. The spectral CT images were analyzed by two radiologists with more than five years of experience in CT diagnosis. The volume of the both lower limbs were measured using the threshold value software. Based on the percentage increase in the volume of the affected side compared to the healthy side, the enrolled patients were divided into three grades: mild, moderate, and severe. Percentage fat volume fraction (FVF) images were generated by using the MMD algorithm on spectral CT to measure the fat content of the affected and healthy lower limbs respectively. Paired &lt;i&lt;t&lt;/i&lt; test were used to analyze the difference of the percentage FVF between the affected and healthy side in mild, moderate, severe patients. Results: Forty patients (female/male, 36/4 cases, with age range of 32-71 years old, median age of (53±10) years) were finally enrolled, and the course of disease was (3±5) years. There were 8 cases in mild group, 14 cases in moderate group and 18 cases in severe group. There were statistical differences in the percentage FVF between the affected and healthy side in mild, moderate and severe patients. There was no statistical difference in the percentage FVF of the affected side among mild, moderate and severe patients.Conclusion: The spectral CT MMD algorithm can quantify the percentage FVF of Secondary Lower Extremity Lymphedema, but it cannot be used alone in the grading of secondary lower extremity lymphedema.
- spectrum CT /
- MMD /
- lower extremity lymphedema /
- grade

HTML全文

图 1 能谱CT平扫下肢轴面图像，分别选取患侧与健侧同层面为感兴趣区，该截面患侧和健侧肢体脂肪体积（cm³）分别为26.1±152.4和22.0±169.1

Figure 1. The axial image of lower extremity by spectral CT plain scan. The same section of the affected and healthy side were selected as the ROIs, the fat volume of the affected and healthy side on this section (cm³) is 26.1±152.4 and 22.0±169.1, respectively

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图 2 下肢轴面脂肪体积分数CT图像，分别选取患侧与健侧同层面为感兴趣区，该截面患侧和健侧肢体脂肪体积分数（％）分别为：66.42±37.83和64.83±40.79

Figure 2. The axial FVF image of the lower extremity. The same section of the affected and healthy side were selected as the ROIs, the percentage FVF of the affected and healthy side on this section is 66.42±37.83 and 64.83±40.79, respectively

下载: 全尺寸图片幻灯片

表 1 能谱CT阈值法测量患侧与健侧下肢体积

Table 1 The volume of the affected and healthy side by spectral CT threshold value software

分级\部位	体积/cm³		统计检验
分级\部位	患侧	健侧	t	P
全组（n=40）	9962±2261	6762±1422	11.302	0.000
轻度（n=8）	8358±2213	7379±1862	8.126	0.000
中度（n=14）	8705±1701	6547±1314	15.460	0.000
重度（n=18）	10684±1864	6927±1376	15.487	0.000

下载: 导出CSV

表 2 能谱CT多物质解析算法测量患侧与健侧下肢脂肪体积分数

Table 2 The percentage FVF of the affected and healthy side by spectral CT MMD algorithm

分级\部位	脂肪体积分数/％		统计检验
分级\部位	患侧	健侧	t	P
全组（n=40）	58.00±6.98	54.96±8.71	5.195	0.000
轻度（n=8）	57.98±5.96	55.37±7.53	2.430	0.045
中度（n=14）	58.20±9.08	54.36±10.19	3.987	0.002
重度（n=18）	57.86±5.84	55.25±8.42	2.693	0.015

下载: 导出CSV

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