GSI多参数对肝脏良恶性肿瘤评估的临床意义

目的 探讨宝石能谱CT成像(gemstone spectral imaging,GSI)多参数在肝脏良恶性肿瘤中的变化及对手术可切除性的评估价值。方法 选取2018年5月至2021年8月湖州市第一人民医院收治的89例肝脏恶性肿瘤患者作为恶性组,同期的89例肝脏良性肿瘤患者作为良性组,进行回顾性分析。两组均行GSI检查,比较两组GSI参数能谱曲线斜率(slope of spectral Hu curve,s-SHC)、动脉期标准碘浓度值(normalized iodine concentration,NIC)、门静脉期NIC、碘浓度差值(iodine concentration difference,ICD)、肝动脉碘分数(arterial iodine fraction,AIF)],分析GSI参数对肝脏肿瘤癌变风险的影响及对肝脏良恶性肿瘤的诊断价值。将恶性组根据临床评估情况分为可切除患者(n=28)与不可切除患者(n=61),对比两组患者的GSI参数水平,分析GSI参数对肝癌手术可切除性的评估价值。结果 恶性组s-SHC、动脉期NIC、门静脉期NIC、AIF均高于良性组,ICD低于良...

Clinical significance of GSI multiparameters in the assessment of benign and malignant liver tumours

Objective To investigate the changes of multi-parameters of gemstone spectral CT imaging (GSI) in benign and malignant liver tumors and the evaluation value of surgical resectability. Methods A total of 89 patients with malignant liver tumors admitted to the First People''s Hospital of Huzhou from May 2018 to August 2021 were selected as the malignant group, and 89 patients with benign liver tumors during the same period were selected as the benign group for retrospective analysis. GSI examination was performed for both groups, and the GSI parameters slope of energy spectrum curve (s-SHC), standard iodine concentration in arterial phase (NIC), NIC in portal venous phase, iodine concentration difference (ICD), and hepatic arterial iodine fraction (AIF) ] were compared between the two groups, analyzed the effect of GSI parameters on the risk of liver tumor carcinogenesis and the diagnostic value of benign and malignant liver tumors, and divided the malignant group into resectable patients and unresectable patients according to clinical evaluation, compared the GSI parameter levels of two groups, and analyzed the effect of GSI parameters on the evaluation of surgical resectability of liver cancer. Results The malignant group had higher s-SHC, arterial phase NIC, portal venous phase NIC and AIF than those in the benign group, and lower ICD than that in the benign group, and the differences were statistically significant (P<0.05). The cancer risk of patients with high levels of s-SHC, arterial NIC, portal venous NIC, and AIF was 3.68 times, 2.71 times, 5.85 times, and 3.68 times than those of patients with low levels, and the cancer risk of patients with low ICD levels was 16.80 times that of patients with high levels (P<0.05) . The receiver operating characteristic curve showed that area under the curve of GSI multi-parameter combined diagnosis of liver malignant tumor was 0.933 (95% confidence interval: 0.886-0.965), which was greater than that of each parameter alone (P<0.05); In the malignant group, the s-SHC, arterial phase NIC, portal venous phase NIC, and AIF of the unresectable patients were higher than those of the resectable patients, and the ICD was lower than that of the resectable patients, and the differences were statistically significant (P<0.05); Spearman correlation analysis showed that s-SHC, NIC in arterial phase, NIC in portal venous phase, and AIF were positively correlated with surgical resectable of liver cancer (P<0.05). There was a negative correlation between the resectability of liver cancer surgery (P<0.05); The AUC of GSI multi-parameter combined assessment of surgical resectability was 0.905 (95% confidence interval: 0.824-0.957), which was greater than that of each parameter alone (P<0.05). Conclusions The s-SHC, arterial phase NIC, portal venous phase NIC, and AIF are higher in liver malignant tumors, and the ICD is lower. There are significant differences between GSI parameters and benign tumors. Multi-parameter combined detection is useful for the diagnosis of liver malignant tumors and the evaluation of surgical resectability. It has high application value and can provide guidance for clinical diagnosis and treatment plan selection.