Non-invasive Assessment of Cirrhosis Using Multiphasic Dual-Energy CT Iodine Maps: Correlation with Model for End-Stage Liver Disease Score
Abdominal radiology(2020)
摘要
To determine whether multiphasic dualenergy (DE) CT iodine quantitation correlates with the severity of chronic liver disease. We retrospectively included 40 cirrhotic and 28 non-cirrhotic patients who underwent a multiphasic liver protocol DECT. All three phases (arterial, portal venous (PVP), and equilibrium) were performed in DE mode. Iodine (I) values (mg I/ml) were obtained by placing regions of interest in the liver, aorta, common hepatic artery, and portal vein (PV). Iodine slopes (λ) were calculated as follows: (Iequilibrium–Iarterial)/time and (Iequilibrium–IPVP)/time. Spearman correlations between λ and MELD scores were evaluated, and the area under the curve of the receiver operating characteristic (AUROC) was calculated to distinguish cirrhotic and non-cirrhotic patients. Cirrhotic and non-cirrhotic patients had significantly different λequilibrium-arterial [IQR] for the caudate (λ = 2.08 [1.39–2.98] vs 1.46 [0.76–1.93], P = 0.007), left (λ = 2.05 [1.50–2.76] vs 1.51 [0.59–1.90], P = 0.002) and right lobes (λ = 1.72 [1.12–2.50] vs 1.13 [0.41–0.43], P = 0.003) and for the PV (λ = 3.15 [2.20–5.00] vs 2.29 [0.85–2.71], P = 0.001). λequilibrium-PVP were significantly different for the right (λ = 0.11 [− 0.45–1.03] vs − 0.44 [− 0.83–0.12], P = 0.045) and left lobe (λ = 0.30 [− 0.25–0.98] vs − 0.10 [− 0.35–0.24], P = 0.001). Significant positive correlations were found between MELD scores and λequilibrium-arterial for the caudate lobe (ρ = 0.34, P = 0.004) and λequilibrium-PVP for the caudate (ρ = 0.26, P = 0.028) and right lobe (ρ = 0.33, P = 0.007). AUROC in distinguishing cirrhotic and non-cirrhotic patients were 0.72 (P = 0.002), 0.71 (P = 0.003), and 0.75 (P = 0.001) using λequilibrium-arterial for the left lobe, right lobe, and PV, respectively. The λequilibrium-PVP AUROC of the right lobe was 0.73 (P = 0.001). Multiphasic DECT iodine quantitation over time is significantly different between cirrhotic and non-cirrhotic patients, correlates with the MELD score, and it could potentially serve as a non-invasive measure of cirrhosis and disease severity with acceptable diagnostic accuracy.
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关键词
Dual-energy CT,Liver cirrhosis,Iodine concentration,Material decomposition,Chronic liver disease
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