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首页> 外文期刊>European radiology >CT indices for the diagnosis of hepatic steatosis using non-enhanced CT images: development and validation of diagnostic cut-off values in a large cohort with pathological reference standard
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CT indices for the diagnosis of hepatic steatosis using non-enhanced CT images: development and validation of diagnostic cut-off values in a large cohort with pathological reference standard

机译：使用非增强CT图像诊断肝脏脂肪变性的CT指数：具有病理参考标准的大队列中诊断截止值的开发和验证

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摘要

ObjectivesTo compare the performances of CT indices for diagnosing hepatic steatosis (HS) and to determine and validate the CT index cut-off values.MethodsThree indices were measured on non-enhanced CT images of 4413 living liver donor candidates (2939 men, 1474 women; mean age, 31.4years): hepatic attenuation (CTL), hepatic attenuation minus splenic attenuation (CTL-S), and hepatic attenuation divided by splenic attenuation (CTL/S). The performances of these CT indices in diagnosing HS, relative to pathologic diagnosis, were compared in the development cohort of 3312 subjects by receiver operating characteristic (ROC) analysis. The cut-off values for diagnosing HS >33% in the development cohort were determined at 95% specificity and 95% sensitivity using bootstrap ROC analysis, and the diagnostic performance of these cut-off values was validated in the test cohort of 1101 subjects.ResultsCT(L-S) showed the highest performance for diagnosing HS >= 5% and HS >33% (areas under the curve (AUCs)=0.737 and 0.926, respectively), followed by CTL/S (AUCs=0.732 and 0.925, respectively) and CTL (AUCs=0.707 and 0.880, respectively). For CT scans using 120kVp, the CTL-S cut-off values for highly specific (i.e., -2.1) and highly sensitive (i.e., 7.6) diagnosis of HS >33% resulted in a specificity of 96.4% with a sensitivity of 64.0% and a sensitivity of 97.3% with a specificity of 54.9%, respectively, in the test cohort.ConclusionCT indices using liver and spleen attenuations have higher performance for diagnosing HS than indices using liver attenuation alone. The CTL-S cut-off values in this study may have utility for diagnosing HS in clinical practice and research.Key Points center dot CT indices based on both liver attenuation and spleen attenuation (CT(L-S)and CTL/S) have higher diagnostic performance than CT(L)based on liver attenuation alone in diagnosing HS using various CT techniques.center dot The CT index cut-off values determined in this study can be utilized for reliable diagnosis or to rule out subjects with moderate to severe HS in clinical practice and research, including the selection of living liver donors and the development of cohorts with HS or healthy controls.
机译：ObjectiveSto比较CT指数的表演来诊断肝脏脂肪变性（HS）并确定和验证CT指数截止值。在4413个生物肝脏候选人的非增强CT图像上测量了索引指数（2939名男性，1474名女性;平均年龄，31.4年）：肝衰减（CTL），肝脏衰减减去脾衰减（CTL-S）和肝衰减除以脾衰减（CTL / s）。通过接收器操作特征（ROC）分析，将这些CT指数在诊断HS诊断HS诊断中的性能进行比较。在发育队列中诊断HS> 33％的截止值以95％的特异性和使用自举ROC分析测定95％的灵敏度，并且在1101个受试者的测试队列中验证了这些截止值的诊断性能。结果表格（LS）显示了诊断HS> = 5％和HS> 33％（分别为0.737和0.926的曲线（AUC）下的HS> 33％的最高性能，然后分别为CTL / S（AUCS = 0.732和0.925）和CTL（AUCS = 0.707和0.880）。对于使用120KVP的CT扫描，HS> 33％高度特异性（即-2.1）和高敏感（即7.6）诊断的CTL-S截止值导致96.4％的特异性，灵敏度为64.0％在使用肝脏和脾脏衰减的测试Cohort.conclusionct指数中，特异性分别为54.9％的敏感度为54.3％，对于使用单独使用肝脏衰减的指标，具有更高的性能。本研究中的CTL-S截止值可能具有用于诊断HS临床实践和研究中的HS.KEY点中心点CT CT指数基于肝脏衰减和脾脏衰减（CT（LS）和CTL / S）具有更高的诊断在使用各种CT技术的诊断HS诊断HS时，性能而不是CT（L）。该研究中确定的CT指数截止值CT CT指数截止值可用于可靠的诊断或排除临床中适度至严重HS的受试者实践与研究，包括选择肝脏捐赠者和HS或健康控制的群组的发展。

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  • 来源
    《European radiology》 |2019年第8期|共9页
  • 作者

    Byun Jieun; Lee Seung Soo; Sung Yu Sub; Shin Youngbin; Yun Jessica; Kim Ho Sung; Yu Eun Sil; Lee Sung-Gyu; Lee Moon-gyu;

  • 作者单位

    Univ Ulsan Coll Med Dept Radiol Asan Med Ctr 88 Olymp Ro 43 Gil Seoul 05505 South Korea;

    Univ Ulsan Coll Med Dept Radiol Asan Med Ctr 88 Olymp Ro 43 Gil Seoul 05505 South Korea;

    Univ Ulsan Coll Med Dept Radiol Asan Med Ctr 88 Olymp Ro 43 Gil Seoul 05505 South Korea;

    Univ Ulsan Coll Med Dept Radiol Asan Med Ctr 88 Olymp Ro 43 Gil Seoul 05505 South Korea;

    Univ Ulsan Coll Med Dept Radiol Asan Med Ctr 88 Olymp Ro 43 Gil Seoul 05505 South Korea;

    Univ Ulsan Coll Med Dept Radiol Asan Med Ctr 88 Olymp Ro 43 Gil Seoul 05505 South Korea;

    Univ Ulsan Coll Med Dept Diagnost Pathol Asan Med Ctr 88 Olymp Ro 43 Gil Seoul 05505 South;

    Univ Ulsan Coll Med Div Hepatobiliary Surg &

    Liver Transplantat 88 Olymp Ro 43 Gil Seoul 05505;

    Univ Ulsan Coll Med Dept Radiol Asan Med Ctr 88 Olymp Ro 43 Gil Seoul 05505 South Korea;

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  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 放射医学;
  • 关键词

    Fatty liver; Non-alcoholic fatty liver disease; Tomography; X-ray computed;

    机译：脂肪肝;非酒精脂肪肝病;断层扫描;X射线计算;

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