| Hepatocellular carcinoma (HCC) is one of the most commonmalignancies in the world, which grows aggressively and relapses easilywith high mortality. In recent years, clinical statistics show that, there areabout500thousands died from this disease each year all over the world,accounting for cancer caused of death in the third place. Meanwhile inChina, the incidence of HCC presents an upward trend, accounting forabout55percents in the worldwide. The mortality caused by HCC hasbecome the second place in malignant tumor in China.Currently in the worldwide, the treatment for HCC includeshepatectomy, liver transplantation, catheterradiofrequency ablation,transcatheter arterial chemoembolization (TACE), drug treatment, and soon. In these treatments, the hepatectomy is still the preferred method oftreatment for HCC, which could complete on tumor resection maximallyand make the margin no residual tumor. But in our country, in liver canceroften found has entered the late, so missed the timing of surgery, can onlyuse the hepatic artery chemoembolization for treatment. Treatment withconventional need preoperative the tumor blood supply, to evaluate the hepatic artery, and so on and so forth, is determined by the assessmentoperation, chemotherapy doses and subsequent treatment of the key.Therefore, before the operation of liver lesions qualitative,positioning and fully understand the blood supply situation, is animportant factor decided the success or failure of the conventional TACE.Compared with or dinary spiral CT, Dual-energy CT takes severalinnovation on the pipe and detector, it apply the new kind of detector withmuch purer, higher transparency and more steady performance. Thismakes Dual-energy CT can acquire clearest images and highest resolutionwith lower doses. Besides, it takes diagnose of CT from morphologies tofunction field by its unique energy spectrum grating imaging technology.This improves the accuracy and safety of diagnostic greatly. Dual-energyCT has several advantages, such as low doses imaging, high resolutionimaging, spectral imaging and dynamic500row of imaging, to providecredible evidence for prophase diagnosis. But there’s infrequentinformation and research on the application of Dual-energy CT on HCCand Peripheral vascular infiltration until now.This research through the liver before and after operation of preciousstones energy spectrum CT data analysis, combined with the clinicaloperation records, fully aware of the material energy spectrum of livercancer of precious stones energy spectrum CT attenuation curvecharacteristics, further study of precious stones energy spectrum CT in liver cancer lesions and qualitative diagnosis of peripheral vein invasionability, further explore a noninvasive imaging diagnosis of preciousstones energy spectrum CT tool to evaluate the application value in frontof the resection of liver cancer.Purpose:Compared with the traditional mixed energy imaging, this paperdiscusses energy spectrum CT imaging in the evaluation of liver cancerchemotherapy embolism single energy preoperative hepatic arterialsystem and the application value of the tumor blood supply arteriesshowed.Method:Collection of jilin university affiliated hospital from January2014toOctober2014confirmed during the period of46cases with no indicationsof HCC patients after surgery with male34cases,12women age35~74,with an average age of54. Main methods of diagnosis for levels of tumormarkers and imaging characteristics of cytology and pathology biopsyresults. All patients were performed energy spectrum CT scans. The GEDiscovery750HDCT scanning imaging equipment, in order to locatelesions in patients with liver and its pathological changes. Firstly, with theaim to location of liver lesions of the patients, we use CT positioning asscanning to scan upper abdomen. The parameters are listed below:voltage120kVp; auto mA technology; thick of5mm;0.625mm×64set for the width of collimator;1.375:1or0.984:1of pitch. And for thearterial phase scan, we use Smart Prep technology to monitor dynamicabdominal aorta, and set the threshold from70to100HU. Themonitoring function will start after the beginning of scanning from8to12seconds, and the portal phase will start after the end of scanning from30to40seconds. The concentration of contrast agent is300mg/m1, andthe dose will be injected through intravenous by high-pressure syringe.The high-pressure injector is set to: the dose of80~100m1, and theinjection rate is3~4ml/s. The arterial phase scan range includes theentire lesion of liver and surrounded lesion, meanwhile, the portal phasescan range covers the entire upper abdomen. The mode of Dual-energyCT is set to Helical-body-large-40mm. The first step is to reconstructhybrid energy image by standard algorithm, thick of2.5~5mm, andacquire the quality control image (QC image). The second step is toreconstruct single energy image for general observing, thick of eachgroup is2.5~5mm, and to acquire the energy images including GSIorigin data for2D and3D reconstruction, thick of each group is0.625~1.25mm. Finally on GE of precious stones energy spectrum CT GSI-view and ADW4.4software analysis the scanning image of properhepatic artery and right hepatic artery contrast, CNR and noise values,and the sharpness of the edge of lesions in the liver artery, proper hepaticartery branch level and intrahepatic artery/liver parenchyma comprehensive score.Result:Based on from January2014to October2014of46cases of livercancer patients during the period of analysis and research, to find themost effective CNR imaging obtained by adopting single energy imagescore was4.3+/-4.3, the system default mode of imaging the imagescore was3.8+/-3.8, QC image score3.3+/-0.6, The most effectiveCNR imaging obtained single energy image score were higher than othertwo groups. And using mixed imaging equipment, system default imagingequipment, and the most effective energy of single image results by filmimaging equipment, the proper hepatic artery and right hepatic artery,discovered by one of the most effective CNR by Kev for the effect ofhepatic artery is stronger than the other two methods, image noiseindicators are significantly stronger than the other way.Conclusion:Energy spectrum CT can best single (50-70kev) on the premise ofnot reduce image quality to enhance the hepatic artery with normal livertissue and tumor blood vessels supplying the contrast display. |
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