Diagnostic Efficacy Of Energy Spectrum CT Quantitative Parameters In Distinguishing Hepatocellular Carcinoma,Hepatic Hemangioma And Liver Metastases

Objective: To explore the diagnostic efficacy of energy spectrum CT quantitative parameters in distinguishing hepatocellular carcinoma,hepatic hemangioma and liver metastases by analyzing the parameters of energy spectrum CT imaging of hepatocellular carcinoma,hepatic hemangioma and liver metastases.Methods:(1)33 patients with hepatocellular carcinoma,20 patients with hepatic hemangioma and 17 patients with liver metastases were scanned with 256 slice Revolution CT of GE company in USA.Plain CT scan of upper abdomen,enhanced scan delay phase,enhanced scanning of arterial phase and portal venous phase in energy spectrum mode were performed.Intestinal preparation was required before examination,and the patients were in supine position.All the patients signed the informed consent form,and the ethical code is YYFY-LL-2023-119(2)The scanned data were transferred to the AW4.6 workstation for post-processing,and the CT value,slope of energy spectrum curve,normalized iodine concentration,iodine concentration ratio,lesion-normal liver tissue ratio and effective-Z at the40-140 Ke V single energy level(each interval 10 Ke V)of the outlined region of interest need to be measured.(3)The above data were analyzed by spss26.0 statistical software,using the statistical methods of two groups of independent sample t-test and multi-group one way analysis of variance,the difference was considered statistically significant at P<0.05.Then the data with statistically significant diagnostic parameters of each focus were selected to draw the receiver operating characteristics curve,and the area under the curve,sensitivity and specificity were recorded.Results:(1)The average CT values at 70 and 90 Ke V in arterial phase in HCC group were significantly higher than those in HH group,and the difference was statistically significant(P<0.05),and the average CT values at 40-140 Ke V in arterial phase and 50、70-140 Ke V in portal venous phase in HCC group were significantly higher than those in LM group,and the difference was statistically significant(P<0.05),the average CT values at100-140 Ke V in arterial phase and 70-140 Ke V in portal venous phase in HH group were significantly higher than those in LM group,and the difference was statistically significant(P<0.05).(2)Differences of normalized iodine concentration in portal venous phase and iodine concentration ratio were statistically significant(P<0.05)between hepatocellular carcinoma group and hepatic hemangioma group.The value of the former parameter in hepatic hemangioma group was higher than that in hepatocellular carcinoma group.the value of the latter parameter in hepatic hemangioma group was lower than that in hepatocellular carcinoma group.(3)The ratio of lesion-normal liver tissue in arterial phase in hepatocellular carcinoma group was higher than that in liver metastasis group,and the difference was statistically significant(P < 0.05).(4)The best energy spectrum parameter to distinguish HCC from HH is ICR,the area under the curve is 0.766,the sensitivity is 75.8% and the specificity is 65%.The second was the NIC of portal venous phase,the area under the curve was 0.715,the sensitivity was 87.9%,and the specificity was 50%,and the average CT value at the70 Ke V level of arterial phase,the area under the curve was 0.667,the sensitivity was 72.7%,the specificity was 55%.The best energy spectrum parameters for distinguishing HCC and LM are the average CT value under the arterial phase 100 Ke V level,the area under the curve is 0.772,the sensitivity is 100%,the specificity is 47.1%,and the average CT value under the120 Ke V level of portal vein phase is 0.767,the sensitivity is 93.9%,the specificity is 58.8%.Conclusion:(1)The quantitative parameters of spectral CT are helpful to distinguish HCC from HH and HCC from LM.(2)ICR and NIC in the portal venous phase have great value in the differential diagnosis of HCC and HH(3)The average CT value at the level of100 Ke V in the arterial phase and 120 Ke V in the portal venous phase has a significant value in the differential diagnosis of HCC and LM.(4)The quantitative parameters of energy spectrum CT provide great application value for the diagnosis,differential diagnosis and treatment of diseases.