| Part ⅠThe Study on the equivalence of 80kV images and linear blending images in the dual energy CT scanning of the parotid gland lesionsObjective:To explore the equivalence of 80kV images and conventional linear fusion images in the double energy scanning of parotid occupying lesionsMethods:We retrospectively analyzed 94 cases of parotid occupying patients in our hospital which underwent double-source CT scan and obtained pathologi-cal confirmation..All patients underwent routine scanning and double energy en-hanced dual-phase scan.Combined with sinogram affirmed iterative reconstruct-ion,filtered back prejection and linear blending technology.The images of eac-h patient were divided into groups A(80Kv/FBP),B(80Kv/SAFIRE(3)),C(0.3 LB/FBP)and D4(0.3LB/SAFIRE(3)).Comparative and analysis the carotid arter-y,normal parotid gland,CT values of parotid gland lesions,signal to noise ra-tio,contrast to noise ratio,air background noise,CT value and SNR of masse-ter,image quality score of images about four groups..Results:①Normal parotid CT value and SNR,lesions CNR of A,B,C,D g roups’ differences have no statistical significance(P>0.05),The differences a-mong the four groups’ parotid CNR,lesions CT value and SNR,masseter’s CT value and SNR,the SNR,CNR and CT value of carotid artery,background n oise were statistically significant(P<0.05).②the background noise,parotid CN R,lesions SNR,masseter SNR of group A were all significantly lower than th ose of group B,C and D(P<0.05),however,there was no significant differe nce between group B and group C.(P>0.05),groups D and A,B,C have si gnificant differences(P<0.01).③the lesions CT value,masseter CT value,car otid artery CT value,SNR and CNR of A,B,C,D groups’ differences have s tatistically significance(P<0.05),the lesions,masseter and carotid artery CT v alues among group A,group B,group C and group D have no significant stati stical differences(P>0.05),but the lesions,asseter and carotid artery CT valu es of group A and group B were higher than group C and D,the differen-ces were statistically significant(P<0.05);the carotid SNR and CNR among the group A,group C,group B and group D have no statistical significances(P>0.05),but the carotid SNR and CNR of group A and group C are lower than that of group B and group D,the differences were statistically significant(P<0.05).④There were no significant differences subjective scores among the four groups(P>0.05).Conclusion:In double-source CT dual-energy scan of the parotid gland,80 kv tube images’ quality are similar with linear blending images,and satisfy the re-quirement of diagnosis,can be used as a low dose scanning project applicatio-n;Combined with SAFIRE technology,the image quality can be further impro-ved with the potential to reduce the radiation dose.Part ⅡThe value of optimal single energy image combined with morphological analysis in the diagnosis of benign and malignant parotid lesions.Objective:To explore the value of optimal single energy image in Dual-sour-ce CT dual-energy technology combined with morphological analysis in the di--agnosis of benign and malignant parotid tumors.Methods:Clinical data are the patients of part I eliminate 4 cases inflammato-ry lesions and 1 case of deep deformity,a total of 89 cases,scanning methods are same as part Ⅰ.① Import the reconstructed images to single energy spe-ctrum software,measuring kev 55～80 kev interval 5 kev,a total of 6 group image’s lesion,masseter CT value and SD,calculation and analysis of each R-OI area SNR,CNR and background noise,get the best single energy value.②Combined with the best single energy imaging analysis and record regular mo-rphological characteristics of parotid gland tumors(including site,morpholo gy,Capsule became necrosis,Strengthen the way,the presence of enlarged lym ph nodes),divided into benign and malignant parotid groups,the main signs a-nd the secondary signs were distingu-ished by means of the chi square test an-d Logistic regression.③Comparison and analysis the accuracy of the diagnosi--s of benign and malignant parotid gland of the best single energy images com bi--ned with morphological fea-tures(plan I)and conventional diagnosis(plan II)accuracy rate.Results:①70keV was the optimal single energy value for observation the paro-tid gland tumors.②The parotid gland lesions and peripheral lymph node enlar g-ement of the parotid gland is the main morphological index for the differenti a-l diagnosis of benign and malignant parotid tumors.③The optimal single ener g-y image combined with morpho-logical analysis can improve the diagnostic a c-curacy of benign and malignant parotid tumors.Conclusion:The optimal single energy image combined with morphological analysis can improve the diagnostic accuracy of benign and malignant parotid tumors.The tumor morphology and lymph node enlargement are the main diag-nostic criteria for the diagnosis of benign and malignant parotid tumors.Part ⅢThe value of energy spectrum technique in diagnosis and differential diagnosis of parotid pleomorphic adenoma,aden-olymphomas and malignant tumors of parotid glandObjective:To evaluate the diagnostic value of dual energy spectrum in the diag-nosis and differential diagnosis of parotid pleomorphic adenoma,adenolymphomas and malignantMethods:The general data is the case data the of part I,include parotid pleom-orphic adenoma 32 cases,adenolymphomas 23 cases,malignant tumor 18 cases.A total of 73 cases of parotid gland tumors.Among them,pleomorphic adenomaswe re divided into A and B groups according to their pathological manifestations.In gr oup A,there were 7 cases of peritoneal invasion or incomplete membrane and ric h mucous composition.A total of 25 cases had intact capsule in group B.Instruments and equipment are same as part ⅠResults:① In arterial phase,the energy spectrum curves of the four groups of tu--mor were attenuated,and the difference of the CT values of the four groups has statistically significant(P<0.05),but,there was no significant difference about the CT value among the group A and group B of pleomorphic adenoma and the malign--ant tumor group.(P>0.05),in venous phase,there was no statistically significant dif--f erence about the CT value among the four groups.②In Arterial phase,the 4 grou--ps’ spectrum curve slope is difference and have statistically significant(P<0.05),between the group of adenolymphomas and the group of A and B of pleomorphic adenoma arterial slope difference has statistically difference(P<0.01),there was no statistically significant difference between the group of pleomorphic adenoma and malignant tumor,the group of malignant tumor and pleomorphic adenoma(P>0.05).In venous phase,there was no statistically significant difference about the sl-ope difference among the four groups(P>0.05).Conclusion:It can provide valuable information for the differential diagnosis of parotid adenolymphomas,pleomorphic adenoma and malignant tumor. |
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