光谱 CT 鉴别动脉期高强化肝转移瘤与 肝细胞癌的价值.

Objective To investigate the value of dual-layer detector spectral CT in the differential diagnosis of arterial phase hyperenhancement (APHE) liver metastases and hepatocellular carcinoma (HCC). Methods Fifty-three patients with clinical or pathologically confirmed APHE liver metastasis (23) and HCC (30) from December 2021 to June 2023 were included in this retrospective study . The spectral CT parameters on the standardized virtual monoenergetic image (VMI) including tumor / liver standardized iodine no water (NINW-Ltumor to liver), tumor/liver standardized iodine density (NID-L), tumor/liver standardized Z-effective (NZeff-L), and tumor/abdominal aorta NZeff (NZeff-Atumor to aorta) were calculated. The receiver operating characteristic (ROC) curve and Cohen d were used to analyze the diagnostic effectiveness of these parameters. Results In the arterial phase, the CT values of liver on 40 keV (NCT-L40keV), 50 keV (NCT-L50keV), and 60 keV (NCT-L60keV) VMI, NINW-L, NID-L, NZeff-L and NZeff-A of APHE liver metastases were significantly less than that of HCC (P<0.05). The area under the ROC curve of NINW-L in the arterial phase was the highest at 0.752. The 0.298 threshold value of NINW -L in the arterial phase had the best differentiation between liver metastases and HCC with 63.3% sensitivity and 87.0% specificity. Conclusion NCT-L40keV, NINW-L and NID-L in the arterial phase are valuable for differentiating APHE liver metastasis from HCC. [ABSTRACT FROM AUTHOR]