| Objective:To assess the value of gemstone spectral imaging(GSI)in display blood-supply artery of hepatocellular carcinoma(HCC)residual lesions after transcatheter arterial chemoembolization(TACE)treatment;To evaluate the value of GSI in the diagnosis of hypo-vascular liver neoplasms after TACE treatment.Methods:The clinical data of patients after HCC TACE treatment who were encountered during the period from Feb.2013 to Feb.2016 were retrospectively analyzed.All cases underwent GSI scan in 4~6 weeks after the treatment.The mixed energy(QC)and energy spectrum Mono images were obtained by single CT scanning,Images were retrospectively analyzed using GSI viewer on ADW 4.6 work station.This research include two parts.Part one:42 patients were included this research.In arteial phase images,the contrast noise ratio(CNR)curve function of energy spectrum post-processing software is used to obtain the optimal single energy value corresponding to aorta and normal liver tissue maximum CNR and then get the optimal single image.Two experienced assistant chief physicians who engaged in abdominal imaging diagnosis separately and independently made the reconstruction of blood-supply artery of residual lesions in QC and optimal single energy images.The arteries of the residual lesions were classified and evaluated with these sets of images.The results gained by QC and optimal single energy images were analyzed by paired t-test.Part two: 36 patients were included this research.In arteial phase and portal venous phase images,the contrast noise ratio(CNR)curve function of energy spectrum post-processing software is used to obtain the optimal single energy value corresponding to hypo-vascular liver neoplasms and normal liver tissue maximum CNR and then get the optimal single image.Record CNR values,compare CNR values of QC and optimal single energy images in arterial and portal venous phase images The following two methods were adopted to make observation,(A)QC arterial phase and portal venous phase were used to make observation,(B)to observe the optimal single energy,basis material images and spectrum characteristics.Two experienced assistant chief physicians who engaged in abdominal imaging diagnosis separately and independently made the evaluation of the images on the post processing workstation.The results were compared with DSA findings and follow-up visit.The diagnostic abilities of the two methods were compared using Chi square test.Result Part one: CT detected 52 blood-supply arteries,the optimal single energy of arteries is mostly between 61-65 Ke V.the score of display arteries of QC and optimal single energy image is respectively(1.86±0.68)and(2.60±0.54),the scores of QC images were significantly lower than optimal single energy images(t=8.15,P<0.01),GSI optimal single energy images were better than QC images in display blood-supply artery of HCC residual lesions.Part two: CT detected 82 lesions in 36 patients.The CNR values of QC and optimal single energy image is respectively(3.18±1.20)and(3.85±1.31)in arterial phase.The CNR values of QC and optimal single energy image is respectively(3.85±1.52)and(4.50±1.48)in portal venous phase,both of the datas have significant difference.The sensitivity and specificity of A method were 72.00% and 81.30%,The sensitivity and specificity of B method were94.00% and 90.60%.There were significant differences between the two methods in sensitivity(2?=9.09,P<0.05)and specificity(2?=5.14,P<0.05).Conclusion: Compared with conventional CT,GSI optimal single energy images were better than QC images in display blood-supply artery of HCC residual lesions and hypo-vascular liver neoplasms after TACE treatment.besides,GSI can reflect the homology of the hypo-vascular liver neoplasms and effectively differatate the hypo-vascular tumors from other diseases,proved more information for the follow-up treatment. |
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