Value of spectrum curve from single-source dual-energy noncontrast CT imaging for #br# identifying atypical small hepatocellular carcinnoma from hepatic perfusion disorders
XU Ming-zhe, LIU Ai-lian, SUN Mei-yu, LIU Yi-jun, LI Ye
Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian Liaoning 116011, China
Abstract：Objective: To assess the spectral curve from noncontrast CT imaging in differentiating atypical small hepatocellular carcinnoma(SHCC) from hepatic perfusion disorders(HPD) with single-source dual-energy CT. Methods: Thirty-two histopathologically or clinically proven SHCC and HPD patients, who underwent spectral CT enhancement scanning using spectrum imaging modality(GSI) were retrospectively enrolled with 35 lesions, including 16 SHCC and 19 HPD. The atypical SHCCs were hyperattenuating in arterial phase and nearly isodense in portal venous and equilibrium phases. On polychromatic images(QC images), CT value(CT(QC) value) of SHCC, HPD and appropriate background were measured in noncontrast and arterial phase, and then on monochromatic(40 keV and 140 keV) images, thus the slope of the energy spectrum was calculated. The data from two observers were analyzed with intra-class correlation coefficients(ICC） to assess inter-observer agreement. The differences of CT(QC) value and spectral curve slope between SHCC and liver background, HPD and appropriate background were compared by paired t-test. The differences of CT(QC) value and spectral curve slope between SHCC and HPD on noncontrast and arterial phase images were compared by independent t-test. Results: The inter-observer agreements were good(ICC>0.75). In arterial phase, there were no differences of CT(QC) value or spectral curve slope between SHCC and HPD. On unenhanced imaging, there were no differences of CT(QC) value between SHCC and background, HPD and background, or SHCC and HPD. However, there were significant differences of spectral curve slope between SHCC and background, SHCC and HPD((0.19±0.12) vs (0.00±0.12), (0.19±0.12) vs (0.04±0.17), P<0.05). There was no difference of spectral curve slope between HPD and background. Conclusion: The single-source dual-energy CT noncontrast imaging provides a new convenient, safe and reliable method on the basis of spectral curve features to identify atypical SHCC and HPD which were difficult to differentiate on three phase enhanced imaging by conventional CT.
徐明哲，刘爱连，孙美玉，刘义军，李 烨. 单源双能CT平扫能谱曲线对不典型小肝癌与异常灌注灶鉴别的价值[J]. 中国临床医学影像杂志, 2017, 28(1): 44-48.
XU Ming-zhe, LIU Ai-lian, SUN Mei-yu, LIU Yi-jun, LI Ye. Value of spectrum curve from single-source dual-energy noncontrast CT imaging for #br# identifying atypical small hepatocellular carcinnoma from hepatic perfusion disorders. JOURNAL OF CHINA MEDICAL IMAGING, 2017, 28(1): 44-48.
2017, Vol. 28 
