| Part One One-Stop CT Perfusion Enhances the Advantages of Pancreatic Neuroendocrine TumorsObjective: Based on multiphase dynamic CT enhanced scans and pancreatic neuroendocrine tumors(p NETs)confirmed by pancreatic volumetric perfusion scans,the safety and feasibility of one-stop CT perfusion combined with enhanced pancreatic CT scans were investigated.CT characteristics of tumors at different pathological grades were analyzed.Materials and methods: We prospectively collected 25 patients with suspected p NETs occupying one-stop CT perfusion combined enhanced scan in our hospital;we retrospectively collected 120 patients with p NETs who performed multistage dynamic CT enhanced scan and pancreatic volume perfusion imaging in our hospital during the same period.60 cases.Perfusion parameters and arterial and venous phase images were obtained using CT Perfusion 4D software.(1)The image quality,radiation dose,total amount of contrast agent,total scan time,and economic cost of the three scan modes were compared.(2)To compare the contrast noise ratio(CNR)and perfusion parameters of p NETs with normal parenchyma in one-stop CT perfusion combined enhanced scans.Results:(1)In the one-stop scan enhanced images except for the CT values of the arterial phase of the pancreatic lesions,CNR,CT values of the abdominal aorta and CNR,CT values of the dual-phase pancreatic parenchyma,CT values of the CNR,pancreatic lesion venous phase,and CNR were higher than multi-phase dynamic CT Enhanced,the difference was not statistically significant(p>0.05).(2)The enhancement of arterial phase image noise in the one-stop scan was higher than that in the multi-phase dynamic CT,but the venous phase was lower than the multi-phase dynamic CT enhancement,the differences were not statistically significant(t values were 1.950 and-0.380,respectively,p>0.05).(3)The image noise of pancreatic volume perfusion was higher than that of perfusion image in one-stop scanning,and the difference was statistically significant(t=-17.120,p=0.032).(4)One-stop CT perfusion combined enhanced image subjective quality score was higher than multi-phase dynamic CT enhancement and pancreatic volume perfusion,and all images met the diagnostic requirements,the differences were not statistically significant(U values were 1.787 and 1.457,respectively,p>0.05).(5)One-stop CT perfusion combined with multi-phase dynamic CT enhancement and pancreatic volume perfusion reduced the radiation dose to a different degree,which was reduced by 11.633% and 35.920%,respectively.The difference was statistically significant(F values were 144.201 and 52.949,p<0.05).(6)One-stop CT perfusion combined with enhanced contrast agents was lower than multi-phase dynamic CT enhancement,with a statistically significant difference(F = 1966.520,p = 0.000).One-stop CT perfusion combined enhanced higher than pancreatic volume perfusion,and the difference was not statistically significant(p=0.340).(7)The total scan time of one-stop CT perfusion combined enhancement was lower than that of multi-phase dynamic CT enhancement and pancreatic volume perfusion,the difference was statistically significant(F = 21.452,p = 0.000).(8)One-stop CT perfusion combined with enhanced economic costs was comparable to multi-phase dynamic CT enhancement and a 33.9% reduction compared to pancreatic volume perfusion.(9)The arterial phase CNR of G1 grade p NET was lower than that of G2 grade,which was higher than that of normal pancreatic parenchyma.The difference was statistically significant(F=5.789,p=0.024).G1 grade p NET venous phase CNR was higher than G2 grade,lower than pancreas in normal subjects,the differences were statistically significant(F = 6.467,p = 0.035).(10)The G1 and G2 p NET BF,TTP,MSI,and IRF T0 were higher than the normal parenchyma of the pancreas,and the differences were statistically significant(F values were 35.470,93.912,4.689,and 10.571,respectively,p<0.05).G1 and G2 grades of p NET MTT and PEI were all lower than normal pancreas parenchyma,G2 grades were lower than G1 grade,and the differences were statistically significant(F values were 12.603 and 53.863,respectively,p<0.05).The difference in other perfusion parameters was not statistically significant(p>0.05).Conclusions: 1.One-stop CT perfusion combined with enhanced scans One injection of contrast media to complete the enhancement and perfusion examination is safe and effective,saves inspection time and economic costs,and reduces the radiation dose while maintaining image quality.2.The CNR and perfusion parameters of One-stop CT perfusion combined with enhanced scanning help to identify different pathological grades of p NETs and normal parenchyma of the pancreas.Part Two One-stop CT Perfusion Combined with Enhanced Value in Pancreatic Neuroendocrine Tumor Negative LesionsObjective: To investigate the clinical features and morphological differences of enhanced positive and negative lesions in one-site CT perfusion combined with enhanced p NETs,and to compare the differences in CT parameters between positive and negative p NETs and normal pancreatic parenchyma at different pathological grades.Materials and methods: We prospectively collected 25 cases of patients with suspected p NETs occupying one-stop CT perfusion combined enhanced scan in our hospital,with 43 lesions,of which 25 lesions were positive and 18 lesions were negative.Perfusion parameters and arterial and venous phase images were obtained using CT Perfusion 4D software.1Compare the clinical and CT morphological characteristics of positive and negative p NETs.2 Differences in CNR and perfusion parameters between positive and negative p NETs.3 Differences in CNR and perfusion parameters between positive and negative p NETs and normal parenchyma in different pathological grades.Results:(1)The enhanced positive p NET occurred in the uncinate process,pancreatic head or pancreas is less than the pancreatic body or pancreatic tail.The enhanced negative p NET occurred in the uncinate process,the pancreatic head,or the pancreatic neck more than the pancreatic body or pancreatic tail.The differences were statistically significant.Meaning(p=0.038).There was no significant difference in gender,median age,median diameter of the lesion,whether the capsule was intact,cystic necrosis,presence or absence of calcification,dilation of the pancreatic duct,distant metastasis,and hematogenous spread(p >0.05).(2)One-stop CT perfusion plus enhanced contrast enhanced arterial phase CNR and perfusion parameters BV and MSI of positive p NET were significantly higher than negative p NET(t values were 3.966,2.906,and 3.110,respectively,p<0.05).(3)One-stop CT perfusion plus enhanced scan G1 and G2 enhanced positive p NET was lower than the normal pancreatic substance except MTT and PEI.The double-phase CNR,BV,BF,TTP,MSI,and IRF T0 were higher than the normal parenchyma of the pancreas.Significance(F values were 3.422,60.506,6.787,5.467,30.359,10.711,553.104,15.216,and 14.483,respectively,p<0.05).(4)One-stop CT perfusion combined with enhanced scan G1 and G2 enhanced negative p NETs were higher than normal pancreas except BF,Average,and TTP.Biphasic CNR,MTT,PEI,and Tmax were lower than normal pancreatic parenchyma,and the difference was statistically significant(The F values were 25.921,3.167,110.183,4.789,5.067,10.293,34.686 and 3.466,respectively,p<0.05).The G1 p NETs PS and IRF T0 were lower than the pancreas normal parenchyma,and the G2 p NETs were higher than the normal parenchyma of the pancreas.statistical significance(F values were 3.262 and 9.251,respectively,p<0.05)Conclusions: 1.There was a significant difference in the sites of positive p NETs and negative p NETs in one-stop CT perfusion combined enhancement.2.The CNR and perfusion parameters(BV,MSI,BF,TTP,IRF T0,MTT,PEI,Tmax,Average,PS)obtained by one-stop CT perfusion combined enhancement are helpful for G1 and G2 CT negative and positive p NETs identification of normal pancreatic parenchyma. |
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