通过单次计算机断层扫描图像测量腹围和检测骨骼肌质量

　　诊断性CT扫描为我们分析身体各组成成分提供了机会，其中包括腹围、腹部脂肪组织（皮下，内脏，肌间）和骨骼肌（SM）的测量。在临床中，CT扫描是一种常见的诊断性检查，同时有报道可以用于评估腹围和全身骨骼肌质量。仰卧位测量腹围是对腰围（WC）的有效衡量。CT横断面图像中第三腰部位腹部骨骼肌和全身骨骼肌之间建立了固有的相关性。肌肉减少症指年龄相关性肌肉体积和功能的减少。利用CT评估全身肌肉减少来定义肌肉减少症已经在临床人口中验证并与不良预后明显相关。然而，尽管根据CT扫描获得的SM数据比较实用和精确，并且测量值和临床预后存在一定的相关性，但它并没有列为常规临床营养评估的检查项目。缺乏时间，培训和花费是阻碍临床医师充分利用这项技术的潜在障碍。本教程提供了一套系统的一步一步指导你利用局部诊断性扫描的CT横断面图像来快速量化腹围作为WC和SM指标对肌肉减少症进行临床诊断。虽然有多个软件可供选择，但本教程中使用的是由美国国立研究院开发的免费的公用软件（ImageJ）。

JPEN J Parenter Enteral Nutr. 2016;40(3):308-18.

Measuring Abdominal Circumference and Skeletal Muscle From a Single Cross-Sectional Computed Tomography Image: A Step-by-Step Guide for Clinicians Using National Institutes of Health ImageJ.

Gomez-Perez SL, Haus JM, Sheean P, Patel B, Mar W, Chaudhry V, McKeever L, Braunschweig C.

University of Illinois at Chicago, Chicago, Illinois; Loyola University Chicago, Maywood, Illinois; John H. Stroger Hospital, Chicago, Illinois; University of Illinois Hospital & Health Sciences System, Chicago, Illinois; University of Illinois at Chicago, Chicago, Illinois.

Diagnostic computed tomography (CT) scans provide numerous opportunities for body composition analysis, including quantification of abdominal circumference, abdominal adipose tissues (subcutaneous, visceral, and intermuscular), and skeletal muscle (SM). CT scans are commonly performed for diagnostic purposes in clinical settings, and methods for estimating abdominal circumference and whole-body SM mass from them have been reported. A supine abdominal circumference is a valid measure of waist circumference (WC). The valid correlation between a single cross-sectional CT image (slice) at third lumbar (L3) for abdominal SM and whole-body SM is also well established. Sarcopenia refers to the age-associated decreased in muscle mass and function. A single dimensional definition of sarcopenia using CT images that includes only assessment of low whole-body SM has been validated in clinical populations and significantly associated with negative outcomes. However, despite the availability and precision of SM data from CT scans and the relationship between these measurements and clinical outcomes, they have not become a routine component of clinical nutrition assessment. Lack of time, training, and expense are potential barriers that prevent clinicians from fully embracing this technique. This tutorial presents a systematic, step-by-step guide to quickly quantify abdominal circumference as a proxy for WC and SM using a cross-sectional CT image from a regional diagnostic CT scan for clinical identification of sarcopenia. Multiple software options are available, but this tutorial uses ImageJ, a free public-domain software developed by the National Institutes of Health.

KEYWORDS: abdominal circumference; computed tomography; sarcopenia; skeletal muscle

PMID: 26392166

PMCID: PMC4767633

DOI: 10.1177/0148607115604149