Dual Source CT Energy Imaging Evaluation Of Liver Alveolar Echinococcosis On Blood Flow Imaging And Pathologic Features

Objective:The quantitative data of dual source computer temograghy (DSCT) iodine in hepatic alveolar echinococcosis (HAE) lesions were collected. It was the contrasted with the histopathology of lesions to explore the blood characteristics value of dual-source dual-energy CT imaging iodine in the evaluation of liver hydatid vesicular lesions.Methods:18cases with complete dual-energy dual-source CT scan data (HAE cases were confirmed by surgery and pathology) were collected. Second-generation Siemens Definition Flash dual-source dual-energy CT machine was used for data collection. The raw data was transmitted to the workstation Syngo MMWP for iodine image quantitative analysis, the iodine value in three types of structures were obtained, measured and recorded (solid hydatid organizational structure,the organizational structure around HAE edge area of the lesion and normal liver tissue structure).Wilcoxon signed rank test was used to compare three types of organizational structure iodine value among pairwise enhanced scans. The pairwise comparisons were conducted among three categories of structure, P<0.017was for the significant difference. Spearman method was used for comparison of the three types of structures and correlation of microvascular pathology micro density (MVD) and enhanced value of the CT amplitude in the corresponding region. P<0.05stands for statistically significant difference.Results:1. Three phases of CT dual energy enhanced scanning comparison:â‘ Solid HAE organizational structure in each enhanced scanning periods showed no statistical difference (P>0.017). HEA fringe tissues between arterial phase and portal venous phase and between arterial phase and liver parenchyma phase showed statistically differences (P <0.017), the portal venous phase and liver parenchyma phase showed no statistical difference (P>0.017). The normal liver tissue structures in each period showed all statistically significant (P<0.017).â‘¡Three kinds of structure were pairwise compared at the same time phase. In arterial phase, the iodine value in hydatid and edge area showed no significant statistical difference (P>0.017), the iodine value in edge area and normal liver parenchyma showed statistical differences (P<0.017). In each phase of portal vein and hepatic parenchymal phase, iodine value in three kinds of organization showed pairwise statistical differences (P<0.017).2.â‘ Correlation analysis showed that in each enhanced scanning period, CT measurement area was positively correlated with corresponding pathologic MVD (P<0.05). Correlation coefficient as follows:Solid HAE organizational structure:arterial phase:r=0.775, P=0.000; portal venous phase:r=0.775, P=0.000; liver parenchyma phase:r=0.826, P-0.000. HEA edge structure: arterial phase:r=0.901, P=0.000; portal vein phase:r=0.910, P=0.000; liver parenchyma phase:r=0.865, P=0.000; normal liver tissue structures:arterial phase:r=0.879, P=0.000; portal venous phase:r=0.958, P=0.000; liver parenchyma phase:r=0.900, P=0.000. In three enhancement phase and three kinds of organization, the enhanced CT value range and the corresponding MVD area were generally positively correlated, correlation coefficients were as follows:solid HAE organizational structure: arterial phase:r=0.500, P=0.035; portal venous phase:r=0.510, P=0.030; Liver parenchyma phase:r=0.470, P=0.049, HEA edge structure:arterial phase:r=0.510, P=0.0.030; Portal vein phase:r=0.514, P=0.029; liver parenchyma phase:r=0.542, P=0.032; normal liver tissue structures:arterial phase:r=0.477, P=0.045; portal venous phase:r=0.508, P=0.032, the liver parenchyma phase:r=0.509; P=0.040.â‘¡In three periods of the dual energy enhancement scanning and three kinds of organization structure, difference significance test results between iodine value, the corresponding CT value enhancement levels and MVD were as follows:In arterial phase, solid HAE organization iodine value had no statistical difference with the CT enhanced range (P=0.020); Edge organization iodine value had no statistical difference with CT enhanced range (P=0.150). Liver parenchyma iodine value had no statistical difference with CT enhanced range (P=0.080). In portal venous phase, solid HAE iodine value had no statistical difference with CT enhanced range (P=0.020), Edge organization iodine value had no statistical difference with CT enhanced range (P=0.010); The liver parenchyma iodine value had no statistical difference with CT enhanced range (P=0.048). In liver parenchyma phase, solid HAE iodine value had no statistical difference with CT enhanced range (P=0.040), Edge organization iodine value had no statistical difference with CT enhanced range (P=0.002); The liver parenchyma iodine value had no statistical difference with CT enhanced range P=0.040). It was suggested that iodine quantitative method was superior to CT enhanced range method in evaluating blood supply characteristics of HAE lesion.Conclusion:dual source CT dual energy imaging iodine quantitative technology can better reflect the blood flow characteristics of HAE lesions, it is expected to be a simple and conventional method in clinical evaluation and follow-up of blood flow characteristics of HAE.