{"title":"延迟双能CT细胞外体积不同成像时间点评价肝纤维化分期的比较。","authors":"Chuanlin Yu, Wanjing Zhou, Yingjie Peng, Ting Dai, Peng Liu, Yaqiong He","doi":"10.1093/bjr/tqaf177","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To stage liver fibrosis by using delayed dual-energy CT (DECT) and determine the optimal delay time for acquisition of delayed CT scans.</p><p><strong>Materials and methods: </strong>This prospective study included patients with chronic liver disease, who were scheduled to undergo multiphase abdominal DECT (including 3-min and 5-min delayed periods) and liver biopsies from January 2021 to December 2021. The iodine densities of the parenchyma and aorta were measured and extracellular volume (ECV) was calculated. Kendall rank correlation was employed to assess the relationship between the ECV and the fibrosis stage. Comparison of ECVs was made for different stages of liver fibrosis. In addition, the diagnostic performances of ECV for staging liver fibrosis were evaluated by using receiver operating characteristic (ROC) curve analysis, and area under the ROC curve (AUC) was calculated.</p><p><strong>Results: </strong>A total of 90 participants were evaluated, and distributed as follows: 10 in S1, 29 in S2, 25 in S3, and 26 in S4. Both ECV of 3-min delayed (ECV3 min) and 5-min delayed (ECV5 min) showed a positive correlation with the stage of liver fibrosis (ECV3 min: τ = 0.478, P ＜ 0.01, moderate correlation; ECV5 min: τ = 0.352, P ＜ 0.01, weak correlation). In terms of diagnostic performances, ECV3 min showed significantly higher diagnostic accuracy than ECV5 min for significant liver fibrosis (S2-4) (AUC: 0.87 vs. 0.79, P = 0.037), but no significant differences were observed for progressive fibrosis (S3-4) (AUC: 0.76 vs. 0.71, P = 0.206) or cirrhosis (S4) (AUC: 0.75 vs. 0.74, P = >0.774).</p><p><strong>Conclusion: </strong>DECT ECV may have some potential in noninvasively liver fibrosis staging, ECV3 min is not definitely inferior to ECV5 min.</p><p><strong>Advances in knowledge: </strong>A 3-min delay for the delayed-phase ECV assessment can guide clinical treatment decisions for patients and enhance the efficiency of scanning work, holding significant clinical value.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8000,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Comparison of the different imaging time points in delayed Dual-Energy CT extracellular volume in assessing the staging of liver fibrosis.\",\"authors\":\"Chuanlin Yu, Wanjing Zhou, Yingjie Peng, Ting Dai, Peng Liu, Yaqiong He\",\"doi\":\"10.1093/bjr/tqaf177\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To stage liver fibrosis by using delayed dual-energy CT (DECT) and determine the optimal delay time for acquisition of delayed CT scans.</p><p><strong>Materials and methods: </strong>This prospective study included patients with chronic liver disease, who were scheduled to undergo multiphase abdominal DECT (including 3-min and 5-min delayed periods) and liver biopsies from January 2021 to December 2021. The iodine densities of the parenchyma and aorta were measured and extracellular volume (ECV) was calculated. Kendall rank correlation was employed to assess the relationship between the ECV and the fibrosis stage. Comparison of ECVs was made for different stages of liver fibrosis. In addition, the diagnostic performances of ECV for staging liver fibrosis were evaluated by using receiver operating characteristic (ROC) curve analysis, and area under the ROC curve (AUC) was calculated.</p><p><strong>Results: </strong>A total of 90 participants were evaluated, and distributed as follows: 10 in S1, 29 in S2, 25 in S3, and 26 in S4. Both ECV of 3-min delayed (ECV3 min) and 5-min delayed (ECV5 min) showed a positive correlation with the stage of liver fibrosis (ECV3 min: τ = 0.478, P ＜ 0.01, moderate correlation; ECV5 min: τ = 0.352, P ＜ 0.01, weak correlation). In terms of diagnostic performances, ECV3 min showed significantly higher diagnostic accuracy than ECV5 min for significant liver fibrosis (S2-4) (AUC: 0.87 vs. 0.79, P = 0.037), but no significant differences were observed for progressive fibrosis (S3-4) (AUC: 0.76 vs. 0.71, P = 0.206) or cirrhosis (S4) (AUC: 0.75 vs. 0.74, P = >0.774).</p><p><strong>Conclusion: </strong>DECT ECV may have some potential in noninvasively liver fibrosis staging, ECV3 min is not definitely inferior to ECV5 min.</p><p><strong>Advances in knowledge: </strong>A 3-min delay for the delayed-phase ECV assessment can guide clinical treatment decisions for patients and enhance the efficiency of scanning work, holding significant clinical value.</p>\",\"PeriodicalId\":9306,\"journal\":{\"name\":\"British Journal of Radiology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.8000,\"publicationDate\":\"2025-07-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"British Journal of Radiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1093/bjr/tqaf177\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"British Journal of Radiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/bjr/tqaf177","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
引用次数: 0
摘要
目的：应用延迟双能CT （DECT）对肝纤维化进行分期，确定延迟CT扫描的最佳延迟时间。材料和方法：本前瞻性研究纳入慢性肝病患者，计划于2021年1月至2021年12月进行多期腹部DECT（包括3分钟和5分钟延迟期）和肝脏活检。测定肺实质和主动脉碘密度，计算细胞外体积（ECV）。采用肯德尔秩相关评价ECV与纤维化分期的关系。比较不同阶段肝纤维化的ecv。此外，采用受试者工作特征（ROC）曲线分析评价ECV对肝纤维化分期的诊断价值，并计算ROC曲线下面积（AUC）。结果：共评估了90名参与者，分布如下：S1 10人，S2 29人，S3 25人，S4 26人。延迟3 min （ECV3 min）和延迟5 min （ECV5 min）的ECV均与肝纤维化分期呈正相关(ECV3 min: τ = 0.478, P < 0.01，中度相关；ECV5 min: τ = 0.352, P < 0.01，弱相关)。在诊断性能方面，ECV3 min对严重肝纤维化（S2-4）的诊断准确率显著高于ECV5 min (AUC: 0.87 vs. 0.79, P = 0.037)，但对进行性纤维化（S3-4） （AUC: 0.76 vs. 0.71, P = 0.206）或肝硬化（S4） （AUC: 0.75 vs. 0.74, P = >0.774）的诊断准确率无显著差异。结论：DECT ECV在无创肝纤维化分期中可能有一定的潜力，ECV3 min并不一定低于ECV5 min。知识进步：迟发期ECV评估延迟3 min，可指导患者的临床治疗决策，提高扫描工作效率，具有重要的临床价值。
Comparison of the different imaging time points in delayed Dual-Energy CT extracellular volume in assessing the staging of liver fibrosis.
Objective: To stage liver fibrosis by using delayed dual-energy CT (DECT) and determine the optimal delay time for acquisition of delayed CT scans.
Materials and methods: This prospective study included patients with chronic liver disease, who were scheduled to undergo multiphase abdominal DECT (including 3-min and 5-min delayed periods) and liver biopsies from January 2021 to December 2021. The iodine densities of the parenchyma and aorta were measured and extracellular volume (ECV) was calculated. Kendall rank correlation was employed to assess the relationship between the ECV and the fibrosis stage. Comparison of ECVs was made for different stages of liver fibrosis. In addition, the diagnostic performances of ECV for staging liver fibrosis were evaluated by using receiver operating characteristic (ROC) curve analysis, and area under the ROC curve (AUC) was calculated.
Results: A total of 90 participants were evaluated, and distributed as follows: 10 in S1, 29 in S2, 25 in S3, and 26 in S4. Both ECV of 3-min delayed (ECV3 min) and 5-min delayed (ECV5 min) showed a positive correlation with the stage of liver fibrosis (ECV3 min: τ = 0.478, P ＜ 0.01, moderate correlation; ECV5 min: τ = 0.352, P ＜ 0.01, weak correlation). In terms of diagnostic performances, ECV3 min showed significantly higher diagnostic accuracy than ECV5 min for significant liver fibrosis (S2-4) (AUC: 0.87 vs. 0.79, P = 0.037), but no significant differences were observed for progressive fibrosis (S3-4) (AUC: 0.76 vs. 0.71, P = 0.206) or cirrhosis (S4) (AUC: 0.75 vs. 0.74, P = >0.774).
Conclusion: DECT ECV may have some potential in noninvasively liver fibrosis staging, ECV3 min is not definitely inferior to ECV5 min.
Advances in knowledge: A 3-min delay for the delayed-phase ECV assessment can guide clinical treatment decisions for patients and enhance the efficiency of scanning work, holding significant clinical value.
期刊介绍：
BJR is the international research journal of the British Institute of Radiology and is the oldest scientific journal in the field of radiology and related sciences.
Dating back to 1896, BJR’s history is radiology’s history, and the journal has featured some landmark papers such as the first description of Computed Tomography "Computerized transverse axial tomography" by Godfrey Hounsfield in 1973. A valuable historical resource, the complete BJR archive has been digitized from 1896.
Quick Facts:
- 2015 Impact Factor – 1.840
- Receipt to first decision – average of 6 weeks
- Acceptance to online publication – average of 3 weeks
- ISSN: 0007-1285
- eISSN: 1748-880X
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