目的:爬行脂肪是克罗恩病肠道病变部位特有的一种异常肠系膜组织。通过使用双能量CT小肠造影,本研究旨在评估光谱参数在肠系膜脂肪组织或蠕动脂肪定量分析中的可行性。
方法:在本研究中,纳入2019年3月1日至2021年3月31日接受双能量CT小肠造影的已知或疑似克罗恩病患者.其中,选择经手术和病理证实的蠕脂克罗恩病组40例,选择正常对照组40例。定量光谱参数包括Hounsfield单位曲线的斜率,脂肪-水浓度正常化,正常化的脂肪碘浓度,并获得肠溶相的标准化脂肪体积分数。Mann-WhitneyU测试,Kruskal-WallisH测试,和受试者工作特征曲线分析用于比较各组之间的定量参数。
结果:在Hounsfield单位曲线的斜率中观察到显着差异,脂肪-水浓度正常化,正常化的脂肪碘浓度,肠系膜脂肪组织与克罗恩病的蠕动脂肪之间的脂肪体积分数正常化(均p<0.001)。肠溶期蠕动脂肪的Hounsfield单位曲线的斜率具有更好的区分非活动性和活动性克罗恩病的能力(AUC=0.93,p<0.001)。
结论:具有定量波谱参数的双能量CT小肠造影是评估克罗恩病中爬行脂肪的潜在新型无创工具。
■克罗恩病中爬行脂肪的能谱参数与正常肠系膜脂肪组织明显不同,并与炎症活动相关。
结论:•双能量CT小肠造影术允许用光谱参数定量评估爬行脂肪。•爬行脂肪具有与正常肠系膜脂肪不同的光谱参数。•光谱参数准确区分活动性和非活动性克罗恩病。
OBJECTIVE: Creeping fat is a kind of unique abnormal mesenteric tissue at the sites of diseased bowel of Crohn\'s disease. By using dual-energy CT enterography, this study aimed to evaluate the feasibility of spectral parameters in the quantitative analysis of mesenteric adipose tissue or creeping fat.
METHODS: In this study, patients with known or suspected Crohn\'s disease who underwent dual-energy CT enterography from March 1, 2019, to March 31, 2021, were enrolled. Among them, 40 patients with surgery and pathology-proven creeping fat were selected as the creeping fat Crohn\'s disease group, and 40 normal patients were selected as the control group. The quantitative spectral parameters including the slope of the Hounsfield unit curve, normalised fat-water concentration, normalised fat-iodine concentration, and normalised fat volume fraction at the enteric phases were obtained. Mann-Whitney U test, Kruskal-Wallis H test, and receiver operating characteristic curve analysis were applied to compare quantitative parameters among various groups.
RESULTS: A significant difference was observed in the slope of the Hounsfield unit curve, normalised fat-water concentration, normalised fat-iodine concentration, and normalised fat volume fraction between mesenteric adipose tissue and creeping fat with Crohn\'s disease at the enteric phase (all p < 0.001). The slope of the Hounsfield unit curve of creeping fat at the enteric phase had a better capability to distinguish inactive and active Crohn\'s disease (AUC = 0.93, p < 0.001).
CONCLUSIONS: Dual-energy CT enterography with quantitative spectral parameters is a potentially novel noninvasive tool for evaluating creeping fat in Crohn\'s disease.
UNASSIGNED: Energy spectral parameters of creeping fat in Crohn\'s disease are significantly different from normal mesenteric adipose tissues and are correlated with inflammatory activity.
CONCLUSIONS: • Dual-energy CT enterography allows quantitatively assessing creeping fat with spectral parameters. • The creeping fat has distinct spectral parameters to normal mesenteric adipose. • The spectral parameters accurately differentiate active and inactive Crohn\'s disease.