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投稿时间：2019-05-05 网络发布日期：2020-01-20
投稿时间：2019-05-05 网络发布日期：2020-01-20
中文摘要: 目的 用多层螺旋CT(MSCT)薄层扫描三维测量方法观察2型糖尿病(T2DM)患者胰腺体积(PV)、胰体比(PVI)的变化,以期为T2DM的临床研究提供有价值的信息。
方法 采用回顾性研究方法,收集2017年5月至2018年6月在南京中医药大学附属医院住院并经临床诊断为T2DM患者96例为T2DM组,收集同期相同年龄段在消化内镜科、肛肠科及泌尿外科住院排除糖尿病和胰腺疾病且符合纳入、排除标准的患者167例作为正常对照组。采用MSCT腹部平扫+增强扫描,三维PV测量方法,薄层重建图像层厚取1 mm,测量两组对象的PV、计算PV与体表面积的比值即胰体比(PVI),并进行比较,以了解T2DM患者的PV、PVI变化情况。
结果 正常对照组中,男性的PV［(80.85±15.27)cm3 vs (64.09±14.43)cm3,P=0.000］和PVI［(42.75±6.90)cm3/m2vs (38.23±7.37)cm3/m2,P=0.000］分别大于女性;T2DM组中,男性的PV大于女性［(65.76±13.50)cm3 vs (57.61±16.89)cm3,P=0.010］,男性的PVI与女性相近［(34.13±6.50)cm3/m2vs(33.34±8.17)cm3/m2,P=0.615］;正常对照组男性和女性的PV、PVI均大于相同性别T2DM患者(P<0.05,P<0.01)。用PVI判别研究对象是否为T2DM,在男性,当阈值取39.89 cm3/m2,其ROC曲线下面积(AUC)为0.819,敏感度和特异度为65.2%和88.7%;在女性,当阈值取31.87 cm3/m2,其AUC为0.677,敏感度和特异度为84.0%和48.8%。
结论 用MSCT薄层扫描进行三维PV测量能很好应用于人体的PV评估;T2DM男、女性患者的PV、PVI均较同性别正常对照组明显下降,且T2DM患者男性的PVI下降幅度大于女性,提示当人体PVI下降到一定程度时,T2DM患病风险会显著增加。影像学检查能否在早期发现T2DM患者胰腺的病理变化、进而为T2DM的临床研究提供更多有效信息,有待进行更深入的探讨。
中文关键词: 胰腺体积 2型糖尿病 体层摄影术，X线计算机 三维测量 薄层重建图像
Abstract:Objective To observe the changes of pancreatic volume (PV) and pancreatic volume index (PVI) by multi-slice X-ray computed tomography (MSCT)three-dimensional(3D) thin-layer scanning to provide valuable information for the clinical study of type 2 diabetes mellitus (T2DM).
Methods A total of 96 patients with T2DM hospitalized in the Affiliated Hospital of Nanjing University of Chinese Medicine from May 2017 to June 2018 were retrospectively studied (T2DM group),and 167 patients meeting the inclusion and exclusion criteria(excluding diabetes and pancreatic diseases) at the same period were served as control group.Using MSCT abdominal plain-scan and enhanced scan,3D measurement method and thin-layer reconstruction with image layer thickness of 1 mm,PV was measured,and the ratio of PV to body surface area,ie the pancreatic body ratio(PVI) was calculated,and compared between two groups to understand the changes of PV and PVI in T2DM patients.
Results In control group,male PV［(80.85±15.27)cm3 vs (64.09±14.43)cm3,P=0.000］ and PVI ［(42.75±6.90)cm3/m2 vs (38.23±7.37)cm3/m2,P=0.000］ were statistically higher than those in female,respectively.In T2DM group,male PV was significantly higher than female PV ［(65.76±13.50)cm3 vs (57.61±16.89)cm3,P=0.010］,but male PVI was similar to female PVI ［(34.13±6.50) cm3/m2 vs (33.34±8.17)cm3/m2,P=0.615］.PV and PVI of males and females in control group were significantly higher than those in T2DM group (P<0.05,P<0.01).For male patients,when PVI threshold value was 39.89 cm3/m2,and the area under ROC curve (AUC) was 0.819,the sensitivity and specificity were 65.2% and 88.7%,respectively;for female patients,when PVI threshold value was 31.87 cm3/m2,and AUC was 0.677,the sensitivity and specificity were 84.0% and 48.8%,respectively.
Conclusions 3D PV measurement with MSCT thin-layer scanning can be well applied to PV evaluation of human body.The PV and PVI of male and female patients with T2DM were significantly lower than those of normal controls of the same sex, and the decrease of PVI of male patients with T2DM was greater than that of female patients, suggesting that when human PVI decreased to a certain extent, the risk of T2DM would significantly increase. What needs to be further explored is whether imaging examination can find the pathological changes of pancreas at an early stage and then provide more effective information for clinical research T2DM.
keywords: Pancreatic volume Type 2 diabetes mellitus Tomography,X-ray computed Three-dimensional measurement Thin-layer image reconstruction
文章编号： 中图分类号： 文献标志码：A
基金项目:国家自然科学基金资助项目(81771899);江苏省重大研发计划项目(BE2017772)
| Author Name | Affiliation |
| YUAN Yong-feng,WANG Zhong-qiu,WANG Jian-hua,CUI Can | Department of Radiology,Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing,Jiangsu 210029,China |
引用文本：
袁永丰,王中秋,王建华,崔灿.MSCT三维测量对2型糖尿病胰腺体积变化的研究[J].中国临床研究,2020,33(1):21-26.
袁永丰,王中秋,王建华,崔灿.MSCT三维测量对2型糖尿病胰腺体积变化的研究[J].中国临床研究,2020,33(1):21-26.