Application Value Of Energy Spectral CT Quantitative Parameters In The Staging Of Hepatitis B Hepatic Fibrosis

Objective: To explore the value of quantitative parameters of energy spectrum CT(single energy CT value,attenuation slope of energy spectrum curve,normalized iodine iodine concentration)in the staging of hepatitis B liver fibrosis.Materials and Method: A retrospective analysis of 39 cases of chronic HBV infection with liver fibrosis confirmed by pathology and CT scan of portal vein energy spectrum was performed,and 20 volunteers without liver disease who had accepted portal vein energy spectrum CT scan were collected as normal control group(Normal control group,N group.).On the ADW 4.7 post-processing workstation,the energy spectrum CT quantitative parameters of the right lobe,left lobe and caudate lobe of the liver were measured by the energy spectrum CT post-processing software.The measured parameters included single energy CT value from 40 keV to 140 keV and the iodine(water)concentration,and the attenuation slope of the energy spectrum curve(K)and normalized iodine concentration(NIC)was calculated.At the same time,the liver average energy spectrum CT quantitative parameters were calculated based on the liver trefoil energy spectrum CT quantitative parameters.According to the pathological stage,the patients with hepatitis B liver fibrosis were divided into S1group(S1 stage: 12),S2 group(S2 stage: 11)and S3+S4 group(S3+S4 stage:13).The differences of energy spectrum CT quantitative parameters between N group and different pathological stages of liver fibrosis group was compared by One-way analysis of variance(one-way ANOVA)or Kruskal-Wallis H test,and the least significant difference(LSD)method was used to compare the two groups.The Spearman correlation analysis was used to compare the correlation between the CT quantitative parameters of each energy spectrum and different pathological stages of liver fibrosis.In addition,two independent sample t-tests were used to compare the differences of energy spectrum CT quantitative parameters between liver fibrosis pathological stages <S1 and ≥S1,<S2 and ≥S2 groups,and the receiver operating characteristic(ROC)curve was drawn to evaluate the diagnostic efficacy of each energy spectrum CT quantitative parameters in distinguishing ≥S1 stage and ≥S2stage of liver fibrosis.Result: 1.Energy spectrum CT quantitative parameters,the single-energy CT value of 40 keV-110 keV for the right liver lobe,left liver lobe,caudate liver lobe and liver average is statistically different among the N group,S1 group,S2 group and S3+4 group(P<0.05),the single-energy CT value of 120 keV-130 keV was statistically different in the right liver lobe,left liver lobe and liver average in the N group,S1 group,S2 group and S3+4 group(P<0.05),while 140 keV single-energy CT value was only statistically significant among the left liver lobes in different groups(P=0.005).The K and NIC of the right liver lobe,left liver lobe,caudate liver lobe and liver average of the N group,S1 group,S2 group and S3+4 group was statistically significant(P all less than 0.001).2.There was a negative correlation between the quantitative parameters of energy spectrum CT and different pathological stages of liver fibrosis,and the correlation between K and NIC was stronger than that of single energy CT,among which the correlation of K was the strongest.The correlation between the average K of right liver lobe,left liver lobe,caudate liver lobe and liver average were(r=-0.817,P=<0.001;r=-0.688,P=<0.001;r=-0.721,P=<0.001;r=-0.856,P=<0.001).3.The quantitative parameters of energy spectrum CT were used to distinguish≥S1 stage and ≥S2 stage of hepatic fibrosis.among the single energy CT values,the single energy CT value of 40 keV was the best.The AUC values of he right liver lobe,left liver lobe,caudate liver lobe and liver average were(≥S1: 0.890,0.872,0.823,0.871);(≥S2: 0.859,0.816,0.836,0.850).The K and NIC of he right liver lobe,left liver lobe,caudate liver lobe and liver average in ≥S1 and ≥S2 stages of hepatic fibrosis were significantly lower than those in <S1 and <S2 stages(P < 0.001,respectively).The differentiated AUC values of K and NIC were(≥S1 stage K:0.934,0.924,0.865,0.928;NIC: 0.931,0.937,0.833,0.924);(≥ S2 stage K: 0.938,0.905,0.884,0.923;NIC: 0.951,0.928,0.836,0.922).Conclusions: 1.Energy spectrum CT quantitative parameters are different between the normal control group and the liver fibrosis group of different stages,which is helpful for the evaluation of hepatitis B liver fibrosis stages.2.Energy spectrum CT quantitative parameters are correlated with different stages of liver fibrosis,in which the correlation between the K and NIC was stronger than that of single energy CT value,and the correlation of K was the strongest.3.Energy spectrum CT quantitative parameters showed high differentiation efficiency in distinguishing ≥S1 stage and ≥S2 stage of liver fibrosis,in which the K and NIC were better than single energy CT value,which can provide theoretical basis and numerical reference for the selection of clinical treatment for patients with liver fibrosis.