A Comparative Study On Multi-spot And Parameter Imaging With Spectral CT And Liver Cirrhosis Of Child-pugh Grades

Objective: To explore the value of multi-spot and parameter study with gemstone spectral imaging(GSI) in cirrhotic patients of different Child-Pugh grades.Methods: Totally 58 patients with liver cirrhosis underwent triple-phase enhanced CT scan by GSI mode. Among them, 20 cases were in grade A, 20 cases were in grade B, 18 cases were in grade C. The iodine concentration of left, right and caudate lobe of liver in arterial phase and portal phase, portal vein and spleen in portal phase and abdominal aorta at the same slice were measured. Normalized iodine concentration(NIC) were calculated. Spectral curves of all the spots above were obtained. Slope rates of 40-140 ke V energy range(entire energy range), 40-60 ke V(low energy range), 60-70 ke V(middle energy range), 70-140 ke V(high energy range)were calculated and compared respectively in three grades. The diagnostic performances were evaluated by using ROC analysis.Results: NIC of grade A and C of portal vein in portal phase was 1.16±0.06 and 1.10±0.06 respectively. There were statistical differences between them(P=0.01). NIC of grade A,B,C of spleen in portal phase was 0.68±0.07, 0.64±0.05, 0.55±0.14 respectively. There were statistical differences between grade A and grade C, grade B and grade C(PAC=0.00, PBC=0.04). The low energy range slope rates of grade A,B,C of left lobe of liver in arterial phase were 1.32±0.21, 1.73±0.33, 1.95±0.24 respectively. There were statistical differences between grade A and grade C, grade A and grade B(PAC=0.00, PAB=0.00). The entire energy range slope rates of grade A and C of left lobe of liver in arterial phase were 0.55±0.07、0.69±0.07 respectively. There were statistical differences between them(P=0.00). The low energy range slope rates of grade A and C of right lobe of liver in arterial phase were 1.65±0.36, 1.90±0.22 respectively. There were statistical differences between them(P=0.04). The entire energy range slope rates were 0.60±0.12, 0.67±0.07 respectively. There were statistical differences between them(P=0.03). The low energy range slope rates of grade A and C of caudate lobe of liver in arterial phase were 1.85±0.52, 2.21±0.25 respectively. There were statistical differences between them(P=0.04). The low energy range slope rates of grade A and C of portal vein in portal phase were 8.49±0.52, 7.72±0.60 respectively. There were statistical differences between them(P=0.00). The entire energy range slope rates were 3.44±0.28, 3.13±0.34 respectively. There were statistical differences between them(P=0.02). The low energy range slope rates of grade A and C of spleen in portal phase were 4.59±0.42, 4.21±0.14 respectively. There were statistical differences between them(P=0.01). The entire energy range slope rates were 1.90±0.17, 1.78±0.04 respectively. There were statistical differences between them(P=0.00). Appropriate threshold values were taken, all the sensitivity and specificity was higher than or equal to 66.7%.Conclusion: Liver, portal vein, spleen of different grades had different characteristic on GSI parameters. Multi-spot and parameter study with GSI may be helpful in grading the liver cirrhosis.