The Clinical Application Of CT Morphological Analysis And Energy Spectrum Imaging In Laryngeal Lesions

Part?The Application of MSCT morphological analysis in the diagnosis of laryngeal lesionsObjective To explore the application value of MSCT in the diagnosis and differential diagnosis of laryngeal lesions.Materials and Methods 109 cases of laryngeal lesions in patients with pathologically confirmed and collected with complete clinical data were performed in 128-slice CT scan and enhanced scan,after scanning, the original data were reconstructed with a thin layer of 1mm thickness, and the original axial images and thin layer reconstruction images of all cases were observed,according to the following details of the clinical records and CT signs of lesions :the sex and age of the patient;the lesion site?scope?morphology?edge?density?enhancement degree(plain scan?arterial phase?venous lesions of the CT value)?whether the invasion before and after the joint?epiglottis before the gap and the laryngeal space is invaded?laryngeal cartilage is invaded?whether the transfer of cervical lymph nodes.Results 109 cases of laryngeal lesions in patients with laryngeal squamous cell carcinoma in 76 cases,including 75 males and 1 female,aged 36-75 years,mean 60.6 years;throat benign lesions in 33 cases,including 27 males,6 females,age 38-79 years old,average 57.1 years old.In the comparison of glottic laryngeal squamous cell carcinoma, glottic laryngeal squamous cell carcinoma and transthoracic laryngeal squamous cell carcinoma,there were statistically significant differences in the morphological findings of the six CTs in the range of lesions, the margin,the density,the invasion of the occlusion,the invasion of the laryngeal space,the invasion of the laryngeal cartilage, the cervical lymph node metastasis(P<0.05);the degree of lesion enhancement was not statistically significant(P>0.05).In the comparison of laryngeal polyps, laryngeal squamous epithelial dysplasia, laryngeal cystic lesions, and chronic inflammation of the laryngeal,there were statistically significant differences between the four groups in the comparison of the three CT morphological manifestations of the lesion site, morphology and degree of enhancement(P<0.05);there was no significant difference in the comparison of the lesion margin and density(P>0.05).In laryngeal squamous cell carcinoma and laryngeal benign lesions in the comparison,the differences in the patient's sex and age,lesion site, margin, degree of enhancement,recurrent gap and laryngeal space invasion, laryngeal cartilage invasion, before and after joint violations, cervical lymph node metastasis was statistically significant(P<0.05);while the lesion density was not statistically significant(P>0.05).Conclusion The age and sex of the patient have a certain value in the identification of benign and malignant laryngeal lesions;the regular morphological manifestations of MSCT have definite clinical value in the identification of benign and malignant laryngeal lesions.Part ?Application of virtual non-contrast CT with dual source,dual-energy CT in laryngeal lesions scanningObjective To explore the clinical value of dual-source CT dual energy imaging in virtual non-contrast CT(VNCT) in laryngeal lesions.Materials and Methods A total of 28 patients with laryngeal lesions confirmed by surgery or biopsy confirmed and had complete clinical data were collected,routine pre-contrast scan(ture non contrast;TNC) and arterial phase, venous phase dual energy scan,get Sn140kV, 100kV and weighted linear fusion 120kV image.On the MMWP post-processing workstation, use the "Liver VNC" software to get a virtual scan image and save it.The mean CT values and noise of TNC images and virtual non-contrast(VNC) images were measured for laryngeal lesions and stratified sternocleidomastoid muscle,and then calculate and compare the signal to noise ratio (SNR), contrast noise ratio (CNR) and image quality subjective score,and radiation dose were compared between routine TNC and VNC(expressed by CTDIvol and DLP).Results 28 cases of laryngeal lesions in patients with laryngeal malignant lesions in 16 cases, 12 cases of benign laryngeal lesions.The mean CT, SD, SNR, and CNR values of TNC and VNC images were compared between laryngeal lesions:the mean CT and CNR values of TNC and VNC (A) were statistically significant(P<0.05),and the CNR of VNC (A) is higher than that of TNC;however, there was no significant difference in SD and SNR between TNC and VNC (A)(P>0.05);there was no significant difference in mean CT value,SD,SNR and CNR between TNC and VNC(V)(P>0.05).TNC and VNC images showed good (100%) of laryngeal lesions and lymph node necrosis, laryngeal space violations, and laryngeal cartilage violations.There were no significant differences between the TNC and VNC images of the subjective scores(P>0.05), and the scores were above 4 points.The radiation dose of VNC images was lower than that of TNC(P<0.05),Compared with TNCT,the value of total radiation radiation dose in VNC were significantly reduced by 38%.Conclusion Laryngeal lesions in CT examination,a dual-energy enhanced scan can be used to enhance the image and VNC image,the VNC image is basically the same as the image quality of the TNC image ;and the effective radiation dose of the dual-energy scan is 38% lower than the effective radiation dose of the conventional scan.Dual energy virtual non-contrast CT may be able to replace the ture non-contrast CT.Part ?Application of dual-source CT dual energy iodine and energy spectrum curve in the differentiation of laryngeal precancerous lesion and laryngeal squamous cell carcinomaObjective The multi-parameter analysis of DSCT dual energy technique was used to explore the value of iodine and energy spectrum curve in the differentiation of laryngeal precancerous lesion and laryngeal squamous cell carcinoma.Materials and Methods The scanning method is the same as the second part.Collected by surgery or biopsy pathology confirmed laryngeal squamous cell carcinoma and laryngeal squamous epithelium - severe atypical hyperplasia in 20 patients.The dual-energy scanning arteriovenous images were transferred to the "Liver VNC" software to obtain arteriovenous iodine, and the iodine concentration and normalized iodine concentration were measured.Through the "Mono Energetic"software, we obtained 60-180kev single-band images of arteriovenous phase. The trend of energy spectrum curve was observed and the slope of energy spectrum curve of different lesions was compared.Results 20 cases of laryngeal squamous cell carcinoma and laryngeal squamous epithelium in moderate to severe atypical hyperplasia patients, laryngeal squamous epithelium in moderate to severe atypical hyperplasia in 7 cases, laryngeal squamous cell carcinoma in 13 cases.The CT values of moderate to severe atypical hyperplasia,well-differentiated squamous cell carcinoma and moderate to poorly differentiated squamous cell carcinoma were gradually decreased with the increase of single-energy keV,the higher the keV value, the smaller the decrease of CT value, and the decrease of the energy spectrum curve ;however, there were no significant differences in slope,iodine concentration and normalized iodine concentration between the three different lesions of arteriovenous phase(P>0.05).Conclusion It is impossible to identify the degree of differentiation of laryngeal precancerous lesion and laryngeal squamous cell carcinoma by iodine map and energy spectrum curve in dual source CT dual-energy imaging technique. This conclusion concludes that the sample size should be further confirmed.