Prediction of Hepatosplenic Hemodynamics Combined with Clinical Features Based on Dual-Energy CT for Esophageal Varices at High Risk of Cirrhosis
10.3969/j.issn.1005-5185.2025.03.012
- VernacularTitle:基于双瞬切能谱CT联合临床特征对肝硬化高危食管静脉曲张的预测价值
- Author:
Jiewen CHEN
1
;
Weikang HUANG
;
Liyang YANG
;
Kun MA
;
Tingting CAI
;
Ge WEN
Author Information
1. 南方医科大学南方医院增城院区医学影像科,广东 广州 511300
- Publication Type:Journal Article
- Keywords:
Liver cirrhosis;
Esophageal and gastric varices;
Tomography,X-ray computed;
Blood platelets;
Ascites;
Forecasting
- From:
Chinese Journal of Medical Imaging
2025;33(3):292-297
- CountryChina
- Language:Chinese
-
Abstract:
Purpose To explore the predictive value of hepatosplenic hemodynamic indexes obtained by dual-energy CT combined with clinical features in non-invasive assessment of high-risk esophageal varices(EV)in cirrhosis.Materials and Methods We retrospectively collected 93 patients with cirrhosis from March 2022 to May 2023 in Zengcheng Branch of Nanfang Hospital.All patients underwent epigastric enhanced energy spectrum scan and gastroscopy.EV severity as assessed by gastroscopy(none,EV0;mild,EV1;medium,EV2;severe,EV3)were divided into low-risk EV group(EV0 and EV1)and high-risk EV group(EV2 and EV3).Age,gender,Child-Pugh grade,ascites and platelet of the two groups were collected,and dual-energy CT parameters including liver and spleen volume,mean iodine content in liver and spleen and liver and spleen iodine volume were measured.The difference of parameters between the low-risk EV and the high-risk EV group were analyzed,and the model was constructed by Logistic regression analysis.Receiver operating characteristic curve was used to evaluate the diagnostic performance of the model for high-risk EV.Results There were significant differences in age,Child-Pugh grade,ascites,platelet,liver and spleen volume,liver and spleen iodine volume between low-risk EV and high-risk EV groups(Z/χ2=-5.921-16.343,all P<0.05).Ascites,platelet,liver and spleen volume,liver and spleen iodine volume were included in multivariate regression analysis to construct regression models,and the results showed that spleen iodine volume(OR=1.002,P<0.001),ascites(OR=5.319,P=0.009),platelet(OR=0.99,P=0.062)were independent risk factors for predicting the high risk of EV.Hosmer-Lemeshow test showed that the regression model fit the observed values well(P=0.303),with accuracy of 83.9%,sensitivity of 78.6%,specificity of 88.2%,positive prediction rate of 84.6%and negative prediction rate of 83.3%.The area under the curve of this regression model was 0.894.Conclusion Spleen iodine content based on dual-energy CT,platelet and ascites can noninvasively predict high-risk EV.
