摘要目的:探讨感兴趣区（ROI）位置和大小选择对定量计算机体层摄影术（QCT）测量肝脏脂肪含量的影响。方法:连续抽取2019年12月25日—2020年1月17日在河南省人民医院健康管理科行QCT骨密度检查的98名体检者，采用QCT工作站定量测量肝脏脂肪含量。ROI位置分别定位于肝左叶、右前叶、右后叶，由测量者A、B分别独立测量。测量ROI大小时，固定中心位置，增加ROI的直径，由测量者A测量。采用Friedman检验比较不同位置或不同大小ROI条件下测量结果的差异，采用组内相关系数（ICC）评价测量者间测量结果的可重复性。结果:不同位置ROI条件下测得的肝脏脂肪含量结果的差异有统计学意义（χ2=62.306， P<0.001），不同大小ROI条件下的测量结果差异无统计学意义（χ2=1.088， P=0.581）；测量者A、B在肝左叶、右前叶、右后叶测量结果的测量者间可重复性分析结果的ICC值分别为0.847、0.917、0.874（均>0.750），重复性良好。 结论:QCT技术应用于肝脏脂肪含量测量时，ROI的位置条件可能会影响测量结果，需要在全肝脏选取多个ROI进行测量。QCT在肝脏不同部位的测量者间重复性良好。

abstractsObjective:To explore the effect of the location and size of region of interest (ROI) on the measurement of liver fat by means of quantitative computed tomography (QCT).Methods:A total of 98 subjects who were examined with QCT for bone mineral density examination from December 25, 2019 to January 17, 2020 were recruited continuously from the Department of Health Management of Henan Provincial People′s Hospital. The liver fat content was measured by QCT workstation. The ROI was located respectively in the left lobe, the right anterior lobe and the right posterior lobe of the liver, and it was measured independently by the A measurer and B measurer. The central position of the ROI was fixed and the diameter was increased, and it was measured by the A measurer. In this study, Friedman test was used to compare the differences of measurement results in different positions or sizes of ROI, and intra-class correlation coefficients (ICC) was used to evaluate the repeatability of inter-measurers.Results:There was a significant difference for liver fat content under different positions of ROI (χ2=62.306, P<0.001), but no difference under different seizes of ROI (χ2=1.088, P=0.581). The ICC values of the inter-measurers repeatability analysis of the A measurer and B measurer in the left lobe, right anterior lobe and right posterior lobe of the liver were 0.847, 0.917 and 0.874, all more than 0.75, and the reproducibility was good. Conclusions:When QCT technique is applied to the measurement of liver fat content, the location conditions of ROI may affect results, so it is necessary to select multiple ROI in the whole liver for measurement. The inter-measurers repeatability of QCT in different parts of the liver is good.