透過自製假體量化脂肪肝嚴重程度臨床之研究

Quantification of the Severity of Fatty Liver with Self-Made Phantom

吳沁璇(Sin-Syuan Wu)；彭嘉俊(Chia-Chun Peng)；張孝魁(Hsiao-Kuei Chang)；徐珮倫(Pei-Lun Hsu)；許志清(Jr-Ching Hsu)；高敬堯(Jing-Yao Gao)

超音波 ； 電腦斷層 ； 鐵離子堆積 ； Ultrasound ； Computed Tomography ； Accumulation of Iron Ions

台灣應用輻射與同位素雜誌

20卷1期（2024 / 06 / 01）

2295 - 2300

繁體中文;英文

本研究透過自製不同比例脂肪假體於固定掃描能量條件電腦斷層取得之影像去探討脂肪含量對CT值（Hounsfield unit, HU）之影響，可發現隨著脂肪百分含量增加，HU測量數值之間呈現線性變化，期望能實際體現脂肪沈積量。收集2022年9月至2023年8月，共12個月病人資料，確認病人三個月內是否接受過腹部超音波與電腦斷層掃描檢查（檢查部位包含腹部電腦斷層），紀錄其超音波報告中判定之脂肪肝嚴重程度與肝臟體積平均HU值，由於超音波在重度與其他判定數量不足，最終僅收集有效數據120筆資料（輕度67筆，中度53筆），並透過統計方式進行分析，得出輕度、中度、輕中度全區與假體修正直線方程式，共四條直線分布。在輕度脂肪肝的情況下，基本影測量HU數值結果與臨床判讀較接近，但脂肪肝程度嚴重患者，由於臨床表現肝臟組織中亦會有鐵離子堆積情況產生，因此有低估脂肪含量的情況，而程度越嚴重低估情形也越嚴重。未來假體製作時，將加入鐵離子累積因素納入，結果應會更接近人體表現，如此則可提供臨床醫師更多的臨床診斷資訊，甚至提供肝臟移植影像參考，抑或可將研究與人工智慧偵測軟體結合，提供高水準診斷，讓患者在無恐懼下得到最好的醫療照護品質，提供醫師即時分析結果輔以利判讀。

This study explores the impact of fat content on CT values(Hounsfield unit, HU) through self-made fat prostheses with different proportions using computed tomography images under fixed scanning energy conditions. It can be found that as the fat percentage increases, the HU measurement value decreases. There is a linear change between the parameters, and it is expected to actually reflect the amount of fat deposition. Collect patient data for a total of 12 months from September 2022 to August 2023, confirm whether the patient has received abdominal ultrasound and computed tomography within three months(the examination site includes abdominal computed tomography), and record the ultrasound report To determine the severity of fatty liver and the average HU value of liver volume, due to the insufficient number of ultrasounds for severe and other determinations, only 120 valid data were collected(67 for mild and 53 for moderate), and were analyzed statistically. After analysis, a total of four straight line equations were obtained for mild, moderate, mild to moderate full area and prosthesis correction straight lines. In the case of mild fatty liver, the basic imaging HU value results are close to the clinical interpretation. However, in patients with severe fatty liver, there is also an accumulation of iron ions in the liver tissue due to clinical manifestations, so the fat content may be underestimated, and the more serious the underestimation, the more serious the situation. In the future, iron ion accumulation factors will be included in the production of prostheses, and the results should be closer to human performance. This can provide clinicians with more clinical diagnostic information, and even provide a reference for liver transplantation images, or it can combine research with artificial intelligence detection. The combination of testing software provides high-level diagnosis, allowing patients to receive the best quality medical care without fear, and provides doctors with instant analysis results to facilitate interpretation.