| Objective: The liver is the most important metabolic detoxification organs and the largest digestive organ, has important physiological functions. The liver has a dual blood supply of hepatic artery and portal vein, the three-quarters of blood supply from the portal vein, a quarter of the blood supply from the hepatic artery. Because of its special anatomic structure and abundant blood supply, making it the primary tumors and secondary tumors predilection organ. Among them, liver hemangioma and metastatic tumors are more common in clinical practice. Due to the different treatment and prognosis of both, therefore, the accuracy of both the differential diagnosis has important clinical significance. This study analyzed by gemstone spectral CT image of liver hemangioma and metastases, to explore the application of gemstone spectral CT in the differential diagnosis of liver hemangioma and metastases, and provide a more powerful basis for clinical treatment and prognosis.Methods: Retrospective analysis 30 patients from May 2013 to December 2014 with liver diseases in our hospital. Including 15 cases of liver hemangioma patients( 7 male and 8 female, aged 30~88years, mean age 55.2years); 15 cases with liver metastatic tumors( 9 male and 6 female, aged 51~85years, mean age 64.7years). All inspection are in the GE Discovery CT750 HD 64 slice dual energy CT scans use the energy spectrum scanning mode(Gem Stone Imaging,GSI). Among them, including plain and dynamic enhanced scan, dynamic enhanced scanning including arterial phase, portal venous phase and delayed phase. Each phase scanning single energy image(Mono) using standard reconstruction, layer thickness and layer spacing both are 0.625 mm. On the professional workstation GE AW4.4 into the GSI observation and analysis sytem(GSI viewer), respectively, were observed and meansured the spectrum image in each period of single energy image. Placed the focus region of interest(ROI), kept by the automatic analysis system for the drawing of ROI spectrum curves and data file, the data file contains 40~140ke V(10ke V intervals) of each energy level of CT value(HU), each paired base material concentration(mg/ml)(iodine-water,water-iodine, water-calcium, calcium-water, Iodine-calcium, calcium-iodine), spectral curve and slope. Comparion the of characteristics of plain scan and the enhancement scanning groups in the different energy, content of the base material and the spectral curve slope. Then use SPSS13.0 sofeware, Normal distribution of measurement data with the mean ± standard deviation description, using t-test or approximate t test; Non-normal distribution with M(QR) said, using rank sum test, P<0.05 for the difference has significant meaning.Results: Plain scan of the energy spectrum CT, the liver hemangioma and metastases in 11 different single energy CT those values 40~140(in intervals of 10)were not statistically significant difference, P were greater than 0.05. Spectrum curve liver hemangiomas and metastases showed a rise in type. Its slopes are-0.58±0.12、-0.52±0.12, the difference is not statistically significant(t=-1.349,P=0.188).The spectral analysis of arterial phase image, the liver hemangioma and metastases in 8 different single energy CT those values 40 ~ 110 were statistically significant difference, P were less than 0.05. In 120 ~ 140 kev energy has no statistical significance of CT value of the difference(120ke V,t′=-1.994,P=0.060;130ke V,t′=-1.800,P=0.087;140ke V,t′=-1.628,P=0.120). Spectrum curve liver hemangiomas and metastases in different Traveling, liver hemangioma group spectrum curve showed a rise type, liver metastasis group spectrum curve showed a decreasing type. Its slopes are-0.38±0.10、0.34±0.17, the difference is statistically significant(t=-13.86,P=0.000).The spectrum analysis of the portal venous phase images, the liver hemangioma and metastases in 11 different single energy CT those values 40~140 were statistically significant difference, P were less than 0.05. Spectrum curve liver hemangiomas and metastases showed a decreasing type. Its slopes are 1.19(1.63)、0.67(0.22), the difference is statistically significant(z=-2.905,P=0.003).The spectrum analysis of the portal delayed phase images, the liver hemangioma and metastases in 9 different single energy CT those values 40~120 were statistically significant difference, P were less than 0.05. In 120 ~ 140 kev energy has no statistical significance of CT value of the difference(130ke V,t′=1.940,P=0.063;140ke V,t′=1.730,P=0.095). Spectrum curve liver hemangiomas and metastases showed a decreasing type. Its slopes are 1.13(0.97)、0.25(0.24), the difference is statistically significant(z=-4.003,P=0.000).Each paired base material in the liver hemangiomas group(iodine-water, water-iodine,water-calcium, calcium-water, iodine-calcium, calcium-iodine) were higher than the metastases group, each difference has statistical significance.Conclusions:The use of gemstone spectral CT with monochromatic images and each paired base material concentration, and spectral curve and slope might be helpful for increasing the efficiency and accuracy of the detection and diagnosis of the hepatic tumors. |
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