ISSN 1004-4140
    CN 11-3017/P

    腹腔脏器碘摄取的影响因素及对比剂方案优化:基于双源双能量CT的初步探索

    Factors Influencing Iodine Uptake in Abdominal Organs and Optimization of Contrast Protocols: A Preliminary Study Using Dual-Source Dual-Energy CT

    • 摘要: 目的:基于双源双能量CT扫描仪探索腹腔脏器碘摄取的影响因素,为提高碘摄取稳定性的对比剂案优化提供参考。方法:前瞻性纳入2025年7月至2025年10月期间本院接受腹部CT增强扫描且使用双源双能量CT扫描仪和固定碘对比剂注射方案的患者,重建门脉期扫描碘图。收集患者的年龄、性别、身高、体重、既往史(冠心病、高血压、糖尿病、吸烟史、酗酒史)和辐射剂量;测量患者肝脏、胰腺、脾脏和肾脏的碘摄取;计算患者体重指数、体型特异性剂量评估和有效剂量。采用线性回归评估性别、年龄、体重指数、冠心病、高血压、糖尿病、吸烟史、酗酒史与腹腔实质器官碘摄取的关系。结果:研究共纳入232名患者,其中男性132名(56.90%),年龄的中位数(四分位数)为63.00(51.00,71.00)岁,体重指数22.89(20.83,25.01)kg/m2,其中27名(11.64%)患有冠心病,87名(37.5%)患有高血压,45名(19.40%)患有糖尿病,36名(15.52%)有吸烟史,19名(8.19%)有酗酒史。腹部CT增强检查门脉期扫描的体型特异性剂量评估为6.11(5.39,7.27)mGy,有效剂量为3.18(2.60,4.00)mSv。女性患者肝脏、胰腺、脾脏和肾脏的碘摄取较男性高(P均≤0.006,β=4.016~13.286)。体重指数较大的患者肝脏、胰腺、脾脏和肾脏的碘摄取较低(P均< 0.001,每1 kg/m2β=−1.978~−1.438)。年龄较大的患者胰腺、脾脏和肾脏的碘摄取较高(P均< 0.001,每1岁,β=0.195~0.405)。患有冠心病(P均≤0.032,β=−10.461~−5.351)和患有糖尿病(P均≤0.045,β=−9.537~−3.758)均与胰腺、脾脏和肾脏的碘摄取较低有关,但对于肝脏的碘摄取没有明显影响(P=0.066)。患者是否患有高血压、是否存在吸烟史和酗酒史对于肝脏、胰腺、脾脏和肾脏的碘摄取均没有明显影响(P均≥0.104)。结论:糖尿病、冠心病均与腹部脏器疾病存在独立的病理因果关联,可能升高腹部脏器疾病的发病、重症化及不良预后风险。因此,在调整患者的性别、年龄、体重指数、其他慢性病、吸烟史和酗酒史后,冠心病和糖尿病仍对腹腔脏器的碘摄取存在影响。

       

      Abstract: Objective: To investigate factors associated with iodine uptake in abdominal organs using dual-source dual-energy computed tomography (CT) and to provide evidence for optimizing contrast-enhancement protocols to improve the stability of iodine uptake. Methods: In this prospective study, patients who underwent contrast-enhanced abdominal CT at our institution between July and October 2025 were enrolled. All participants underwent imaging using a fixed iodine contrast-agent injection protocol on a dual-source dual-energy CT scanner. Portal venous phase iodine maps were reconstructed for analysis. Data collected included age, sex, height, weight, medical history (coronary heart disease, hypertension, diabetes mellitus, smoking history, and alcohol abuse history), and radiation exposure. Iodine uptake was measured in the liver, pancreas, spleen, and kidneys. Body mass index (BMI), size-specific dose estimate (SSDE), and effective dose were calculated. Linear regression analysis was performed to evaluate associations between clinical variables and iodine uptake in abdominal organs. Results: A total of 232 patients were included, of whom 132 (56.90%) were male. The median (interquartile range IQR) age was 63.00 (51.00–71.00) years, and the median BMI was 22.89 (20.83–25.01) kg/m2. Among these patients, 27 (11.64%) had coronary heart disease, 87 (37.5%) had hypertension, 45 (19.40%) had diabetes mellitus, 36 (15.52%) had a history of smoking, and 19 (8.19%) reported alcohol abuse. The median SSDE and effective dose were 6.11 (5.39–7.27) mGy, and 3.18 (2.60–4.00) mSv, respectively. Female sex was associated with significantly higher iodine uptake in the liver, pancreas, spleen, and kidneys than male sex (all P≤0.006, β=4.016–13.286). Higher BMI was associated with lower iodine uptake in all organs examined (all P < 0.001; β=−1.978 to −1.438 per 1 kg/m2 increase in BMI). Older age was associated with higher iodine uptake in the pancreas, spleen, and kidneys (all P < 0.001; β=0.195–0.405 per year). Coronary heart disease (all P≤0.032; β=−10.46 to −5.351) and diabetes mellitus (all P≤0.045; β=−9.537 to −3.758) were associated with lower iodine uptake in the pancreas, spleen, and kidneys. Hypertension, smoking history, and alcohol abuse history were not significantly associated with iodine uptake in any abdominal organ (all P≥0.104). Conclusions: Both diabetes mellitus and coronary heart disease are independently associated with abdominal organ diseases and may increase the risk of disease onset, severe progression, and poor prognosis. After adjusting for sex, age, BMI, comorbidities, smoking history, and alcohol abuse history, diabetes mellitus and coronary heart disease remained associated with iodine uptake in abdominal organs.

       

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