Diagnostic Study Of Gallbladder Polyps And Gallbladder Carcinoma By Routine CT And Dual-source CT

Objective:To investigate the diagnostic efficacy of 64-slice spiral CT and third-generation dual-source CT on gallbladder polyps and the imaging characteristics of gallbladder polyps by contrast-enhanced CT.To investigate the diagnostic advantages and clinical value of dual-source CT volume perfusion imaging on gallbladder carcinoma.Methods:1 123 cases of gallbladder polyps in the Deyang People’s Hospital underwent abdominal enhanced CT imaging examinations before operations confirmed by pathology were collected retrospectively from January2015 to November 2019.Compared with the results of 64-slice spiral CT and dual-source CT in the initial diagnosis,the first retrospective diagnosis and the second retrospective diagnosis based on 5mm thickness of multiple plane reformation(MPR)and vascular sign,the imaging features of gallbladder polyps were recorded;and the results of the second retrospective diagnosis were compared with those of ultrasound.2 19 cases of gallbladder lesions with size>1cm in the Deyang People’s Hospital underwent CT imaging examinations were collected from May 2017 to November 2021.The optimal phase,time-attenuation curve(TAC)and perfusion parameters which including blood flow(BF),blood volume(BV),mean transit time(MTT),flow extraction product(FED)were obtained by perfusion scanning images were taken with post-processing software.Compared with the images of gallbladder by different scanning equipment and methods,and analyzed the difference of imaging characteristics between gallbladder benign and malignant lesions;the TAC and perfusion parameters of benign and malignant lesions were compared.Results:1 Compared with the initial diagnosis and the first retrospective diagnosis,the positive rate of the second retrospective diagnosis was significantly improved.55 cases(55/79)were positive in 64-slice spiral CT while 42 cases in dual-source CT(42/44)and 58 cases of in ultrasound(5 8/97);vascular signs were found in 78 of 123 cases(40 cases in 64-slice CT group and 38 cases in dual-source CT group).Cholesterol and adenomatous polyps showed statistically significant differences in lesion size,basal range,and vascular signs(P<0.05).2 Volume perfusion imaging displayed gallbladder lesions,surrounding structures and blood vessels more clearly.There was no statistic difference in FED value between gallbladder benign and malignant lesions(P>0.05),but it showed statistically significant differences in BF,BV and MTT value(P<0.05=。TAC showed that the peak enhancement of gallbladder carcinoma was higher than other gallbladder benign lesions,adenocarcinoma and adenomatous polyp showed high enhancement in early stage,then decreased in late stage.Adenomyosis of gallbladder and cholesterol polyps showed continuous low enhancement.Conclusion:1 The images of 5mm thickness by MPR and vascular signs are helpful to improve the diagnosis of gallbladder polyps.Dual-source CT is better than 64-slice spiral CT and ultrasound;and the differences in lesion size,basal range and vascular signs have differential diagnostic value for cholesterol polyps and adenomatous polyps.2 Dual-source CT volume perfusion imaging has obvious advantages in the early detection,differential diagnosis and staging of gallbladder carcinoma,and can provide reliable basis for clinical diagnosis and treatment.