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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

郭佳, 信建峰, 张春燕, 等. 能谱CT多物质解析评价继发性下肢淋巴水肿分级[J]. CT理论与应用研究, 2022, 31(3): 365-371. DOI: 10.15953/j.ctta.2022.004
引用本文: 郭佳, 信建峰, 张春燕, 等. 能谱CT多物质解析评价继发性下肢淋巴水肿分级[J]. CT理论与应用研究, 2022, 31(3): 365-371. DOI: 10.15953/j.ctta.2022.004
GUO J, XIN J F, ZHANG C Y, et al. Spectral CT multi-material decomposition in evaluation of secondary lower extremity lymphedema: A prospective study[J]. CT Theory and Applications, 2022, 31(3): 365-371. DOI: 10.15953/j.ctta.2022.004. (in Chinese)
Citation: GUO J, XIN J F, ZHANG C Y, et al. Spectral CT multi-material decomposition in evaluation of secondary lower extremity lymphedema: A prospective study[J]. CT Theory and Applications, 2022, 31(3): 365-371. DOI: 10.15953/j.ctta.2022.004. (in Chinese)

能谱CT多物质解析评价继发性下肢淋巴水肿分级

doi: 10.15953/j.ctta.2022.004
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

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

  • 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t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。

     

  • 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

    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

    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
    患侧健侧tP
    全组(n=40) 9962±22616762±1422 11.3020.000
    轻度(n=8) 8358±22137379±1862 8.1260.000
    中度(n=14) 8705±17016547±131415.4600.000
    重度(n=18)10684±18646927±137615.4870.000
    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
    患侧健侧tP
    全组(n=40)58.00±6.9854.96±8.71 5.1950.000
    轻度(n=8) 57.98±5.9655.37±7.53 2.4300.045
    中度(n=14)58.20±9.0854.36±10.193.9870.002
    重度(n=18)57.86±5.8455.25±8.42 2.6930.015
    下载: 导出CSV
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出版历程
  • 收稿日期:  2022-01-07
  • 录用日期:  2022-02-17
  • 网络出版日期:  2022-03-04
  • 刊出日期:  2022-05-23

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