| Object: To comprehensively analyze the morphological and functional characteristics of hepatic alveolar echinococcosis(HAE)by energy spectrum CT multi-parameter imaging and quantitative indexes,and to explore the clinical value of energy spectrum CT imaging in the diagnosis and follow-up of HAE.Methods: 47 patients with hepatic alveolar echinococcosis diagnosed synthetically were collected.All patients underwent conventional abdominal plain scan+energy spectrum CT three-phase enhanced scan.The anatomical structure and morphological information of the lesions were recorded and analyzed,and the lesions were classified by imaging and PNM staging.Through energy spectrum CT imaging post processing reconstruction to obtain the serial function images of lesions,to analysis the characteristics of focus display in each group of images.Thequantitative iodine concentration(QIC)of marginal zone,solid component,cystic component and normal liver parenchyma of HAE lesions were measured and compared on iodine map.And,to analyze the correlation between the QIC of HAE lesion marginal zone,the maximum diameter of lesion and PNM staging.In addition,in order to study the feasibility of VUE in the diagnosis of HAE lesions instead of true unenhanced(TUE),The number of lesions detected,the maximum diameter and the number of calcification detected in TUE and portal venous phase virtual plain scan(PVP-VUE)were recorded and compared.The effective radiation doses of conventional plain scan + energy spectrum three-phase scan and energy spectrum three-phase scan were recorded and compared.Results: 1.A total of 56 HAE lesions(26 solid,8 pseudocystic,and 22 mixed type)with average 9.24±5.60 cm lesion size were assessed.Of the 47 cases,there were 8 cases of stage I,II stage 6 cases,III stage 21 case,IV stage 12 cases.Compared with conventional CT,iodine map shows the edge band of HAE more clearly and has a wider range,and the detection rate of enhancement signs is 76.8% and 58.9%,respectively.The maximum diameters of lesions in CT iodide group and portal vein phase conventional CT were 9.68 ±4.49 cm and 9.24 ±5.60 cm,there is no obvious difference between the two groups(P>0.05).The contrast between HAE and liver parenchyma was the clearest in 65 Ke V energy level.2.The QIC among the marginal zone,solid component,cystic component of alveolar echinococcosis and normal liver parenchyma were statistically significant(P<0.05).The QIC in the marginal zone of HAE lesion was the highest,and the QIC in portal phase and venous phase was significantly different from that in artey phase(P < 0.05).The QIC of marginal zone and lesion diameter of marginal zone were positively correlated with PNM stage(r = 0.642,r = 0.669,P < 0.05).3.The diagnostic sensitivity of VUE and TUE was 91.1% and 94.6%,respectively.The maximum diameters of VUE and TUE were 8.24±4.72 cm and 8.60±4.85 cm,there is no obvious difference between the two groups(P > 0.05).The detection rate of VUE was more than 87.5% for spot-like calcification and 100% for map-like and large patch-like calcification.The effective radiation doses of energy spectrum CT three-phase imaging and conventional CT plain scan + energy spectrum mode are(18.67±2.54)m SV and(23.46±3.67)m SV,respectively,There was a significant difference between the two groups(P<0.01).Conclusion: 1.Energy spectrum CT can provide more information about the anatomical structure,morphology and function of HAE lesions,and QIC of the marginal zone of HAE lesions and the maximum diameter of the lesions are helpful to evaluate the progression of HAE lesions,It has important clinical guiding significance for the diagnosis and follow-up of HAE lesions.2.VUE of energy spectrum CT can be applied to follow-up of HAE lesions. |
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