| Objective:To explore the evaluation value of dual-energy CT multiparameters in different Child-Pugh grades of liver cirrhosis for the characteristics of liver microcirculation perfusion.To explore the clinical value of dual-energy CT multi-parameters in the diagnosis of liver cirrhosis.Methods:Patients diagnosed with cirrhosis and with complete clinical data who underwent upper abdominal dual-source and dual-energy CT enhanced examination in Shaanxi Provincial People’s Hospital from October 2019 to December 2020 were collected as the research subjects,and Child-Pugh classification was performed according to grading standards.Finally,156 cases were included in the liver cirrhosis group,including 46 cases of Child-Pugh grade A,58 cases of Child-Pugh grade B,and 52 cases of Child-Pugh grade C.Sixty normal livers were selected as controls.All scans were performed using Siemens second generation dual source dual energy CT.Dual energy pattern was used to scan the arterial phase and portal vein phase,and dual energy images were collected.The syngo.via post-processing workstation was used to process the data and measure the parameters.Iodine concentration and normalized iodine concentration were measured in the left,right and caudate lobes of the liver at arterial and portal phase,respectively,and the slope of energy spectrum curve of each energy segment(40-70keV,70-100keV,40100keV)was calculated.The average values of the parameters of the above liver lobes were taken as the evaluation parameters of the whole liver.In addition,the volume of liver lobes was measured by semiautomatic measurement software,The total volume of liver was calculated by adding the volume of each lobe,and the iodine storage in each leaf was calculated(the product of iodine concentration and volume).The parameters of liver cirrhosis group and control group were analyzed by two independent samples t test.When the results were different,the ROC curve of each parameter was drawn to evaluate the diagnostic efficiency of each parameter for cirrhosis.Analysis of variance was used to compare the parameters between the control group and the cirrhosis Child-Pugh A,B and C groups.Results:There were no significant differences in iodine concentration,iodine storage,normalized iodine concentration and slope of energy spectrum curve between liver cirrhosis group and normal control group(P>0.05)in arterial phase.Therefore,this study focused on the parameters of portal phase.Iodine concentration,iodine storage,normalized iodine concentration and energy spectrum curve slope of dual-energy CT parameters in portal vein stage showed statistically significant differences between the cirrhosis group and the normal control group(P<0.05),and the liver cirrhosis group was significantly lower than the control group.Various parameters have diagnostic value to liver cirrhosis,and standardization of the right lobe iodine concentration(area under the curve was 0.895,the sensitivity was 95.7%,73.2%),the slope of energy spectrum curve of liver total 40-100 keV energy segment(area under the curve was 0.863,the sensitivity was 75.0%,89.2%),the right lobe iodine storage(area under the curve was 0.855,the sensitivity was 78.3%,95.3%)diagnostic performance better.Except for the left lobe of liver,there were significant differences in the volume of liver lobes and the total volume of liver between the normal control group and the cirrhosis group(P<0.05),and the volume parameters of the liver cirrhosis group were all lower than the normal control group.There were statistical differences in the parameters of portal phase between the normal control group and ChildPugh groups A,B and C(P<0.05),and with the increase of grading,iodine concentration,iodine content,standardized iodine concentration and the slope of energy spectrum curve of each energy segment decreased gradually.The volume of the left lobe,right lobe and total liver decreased with the increase of grading.Except for Child-Pugh A,the volume of the left lobe of liver was larger than that of the normal control group,and the rest were smaller than that of the normal control group.The volume of caudate lobe of liver increased with the increase of grade and was larger than that of normal control group.Conclusion:1.Dual-energy CT multi-parameter in portal vein stage has a certain value in evaluating the changes of microcirculation perfusion characteristics in liver cirrhosis of different Child-Pugh stages;2.Dualenergy CT multi-parameter in portal vein stage has clinical diagnostic value for liver cirrhosis;Dual-energy CT multi-parameter in portal vein stage has a certain value in the evaluation of clinical grading of liver cirrhosis. |
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