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Rofo 2020; 192(12): 1137-1153
DOI: 10.1055/a-1212-6017
Review

Dual-Energy-Computertomografie zur Fettquantifizierung in der Leber und im Knochenmark – ein Literatur-Review

Article in several languages: English | deutsch
Isabel Molwitz
  Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
,
Miriam Leiderer
  Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
,
Cansu Özden
  Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
,
Jin Yamamura
  Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Zusammenfassung

Hintergrund Mit der Dual-Energy-Computertomografie (DECT) ist es möglich, bestimmte Elemente und Gewebe durch ihre spezifische, vom Röntgenspektrum abhängige Abschwächung zu quantifizieren. Diese systematische Übersichtsarbeit bietet einen Überblick über den Einsatz der DECT zur Fettquantifizierung in der klinischen Diagnostik im Vergleich zu etablierten Verfahren wie der Histologie, Magnetresonanztomografie (MRT) oder Single-Energy-Computertomografie (SECT).

Methode Nach systematischer Literaturrecherche wurden sämtliche Studien eingeschlossen, in denen Fettquantifizierung durch die DECT anhand von Vergleichsmodalitäten validiert wurde. Es erfolgte die Aufarbeitung der methodischen Heterogenität der eingeschlossenen Studien. Die Studienergebnisse wurden je Zielorgan und separat nach Vergleichsmodalitäten präsentiert und eingeordnet.

Ergebnisse Es bestand eine hohe Heterogenität der Studienmethodik. Die DECT-Daten basierten auf sequenzieller Generierung, Fast-kVp-Switching-DECT oder Dual-Source-DECT. Die Studien behandelten sämtlich die Eignung der DECT zur Diagnostik der Steatosis hepatis oder zur Bestimmung des Knochenmarkfettanteils und dessen Einfluss auf die Messung der Knochenmineraldichte. Die DECT-Fettquantifizierung in Leber und Knochenmark kommt gegenüber der Histologie, MRT-Chemical-Shift-Relaxometrie, Magnetresonanzspektroskopie und SECT zu validen Ergebnissen. In kontrastmittelgestützten CT-Aufnahmen ist die DECT der SECT zur Diagnostik der Steatosis hepatis klar überlegen. Im Knochen ermöglicht die Bestimmung des Knochenmarkfettanteils über die DECT die zuverlässigere Bestimmung auch des Knochenmineralanteils.

Schlussfolgerung Die DECT ist eine valide Methode zur Fettquantifizierung in Leber und Knochenmark und insbesondere für die Diagnostik der Steatosis hepatis in kontrastmittelgestützten CT-Untersuchungen gegenüber der SECT vorteilhaft. Die Korrektur der Knochenmineraldichte um den durch die DECT bestimmten Knochenmarkfettanteil gestattet eine exaktere Bestimmung der Knochenmineraldichte als konventionelle Methoden. Bei heterogener sowie fehlender Studienlage zur Split-Filter-DECT oder Dual-Layer-Spektral-CT besteht Bedarf an ergänzenden Arbeiten wie auch Potenzial für weitere Studien zur DECT-Fettquantifizierung in anderen Organsystemen.

Kernaussagen:

  • Die Fettquantifizierung in Leber und Knochenmark durch die DECT ist valide möglich.

  • Die DECT-Fettquantifizierung ist der SECT in kontrastmittelgestützten Aufnahmen klar überlegen.

  • Die DECT-Fettquantifizierung im Knochenmark erlaubt die exaktere Bestimmung der Knochenmineraldichte.

  • Es besteht Potenzial für ergänzende Studien zur Dual-Layer-Spektral-CT, Split-Filter-DECT und DECT-Fettquantifizierung in anderen Organsystemen.

Zitierweise

  • Molwitz I, Leiderer M, Özden C et al. Dual-Energy Computed Tomography for Fat Quantification in the Liver and Bone Marrow: A Literature Review. Fortschr Röntgenstr 2020; 192: 1137 – 1153

Key words

CT-quantitative - bone marrow - bone densitometry - dual-energy CT - fat quantification - hepatic steatosis


Publication History

Received: 10 April 2020

Accepted: 11 June 2020

Article published online:
10 September 2020

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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