| Objective:To explore the differential value of gemstone CT(GE Discovery CT 750 HD)betweeen in liver-cirrhosis ascites and malignant ascites,in order to accurately determine the cause of ascites,and provide the effective methods and basis to help clinical diagnosis and treatment the ascites.Material and Methods :(1)The imaging data of 41 patients with ascites diagnosed in our hospital from November 2017 to November 2018 were collected.According to the results of clinical examination and imaging examination,the ascites was divided into liver-cirrhosis ascites group(21 cases).Among them,male 11 and female 10,they were 34-73 years old,and with an average age is(54±10.90)years and another group is malignant ascites group(20 cases),including 12 males and 8 females,they are aged 41-77 years old.And The average age is(60 ± 9.71)years old.(2)The scanning device uses gemstone spectral imaging(GSI)mode scanning using Gem Spectrum CT(GE Discovery CT 750 HD).(3)Transfer the original images of all subjects to the AW 4.6 workstation,and place the three regions of interest(ROI)on the most obvious level of the ascites on the 1.25 mm 140KeV mixed energy image.And the area of each region of interest is about 70mm2,all the regions of interest are placed to avoid the level of artifacts,and the average is taken as the measurement result,so the conventional mixed energy CT value is obtained,and then open the 1.25 mm 70KeV single energy image,and then put that image loading in energy spectrum CT imaging analysis software,also selects the same level of the mixed energy image and the same location to place three regions of interest of the same size to obtain different base material including: water(iodine)concentration,water(Calcium)concentration,(40 ~ 140)kev(at 10 Kev intervals)CT values of each single energy level,effective atomic number,and calculate the slope of the energy spectrum curve.(4)SPSS 19.0 statistical software was used for analysis,compare the mean value of CT values under the mixed energy?the average value of CT values at each energy level of(40-140)KeV(at 10 KeV intervals)?base material concentrations ?EFF-Z?slope K value of the energy spectrum curve between the liver-cirrhosis ascites group and the malignant ascites group according to independent-samples t test;compare the different type of the energy spectrum curve proportion according to Fiche: exact probability test;compare the categorical date between the liver-cirrhosis ascites group and the cancerous ascites group according to Chi-square test;Result(1)Mixed energy CT value: the malignant ascites group(18.43±6.93)was higher than the cirrhosis ascites group(8.90±3.89),the difference has statistically significant(P<0.05).(2)Single-energy CT value: CT values on(40~60)KeV don't show any statistically significant difference between in liver-cirrhosis ascites and malignant ascites(P > 0.05),there were statistically differences between liver-cirrhosis ascites and cancerous ascites at(70~140)KeV(P<0.05)(3)Effective atomic number:liver-cirrhosis ascites group(7.61±0.13)was higher than malignant ascites group(7.47±0.86),the difference has statistically significant(P<0.05).(4)Slope of energy spectrum curve: the malignant ascites group(0.03±0.11)was higher than the cirrhosis ascites group(-0.07±0.14),the difference has statistically significant(P<0.05).(5)Base substance concentration: water(iodine)concentration malignant ascites group(1012.01±6.28)higher than liver-cirrhosis ascites group(1000.56±6.28),water(calcium)concentration malignant ascites group(1012.32)±6.68)was higher than the liver-cirrhosis group(1000.69±6.14),the difference has statistically significant(P<0.05).Conclusion:Spectral CT imaging provides a approach for identifying of liver-cirrhosis ascites and malignant ascites group by mixed energy CT values?single energy CT value(70-140)KeV,water(iodine)concentration,water(calcium)concentration,effective atomic number And the slope of the energy spectrum curve.The energy spectrum CT provides a multi-parameter imaging examination for differential between diagnosis of liver-cirrhosis and malignant ascites. |
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