The value of energy spectrum CT optimal CNR technique in the diagnosis of esophageal and gastric variceal bleeding in liver cirrhosis

Abstract

Abstract: Objective To study on the value of energy spectrum CT best contrast signal-to-noise ratio (CNR) technique in the diagnosis of esophageal variceal bleeding (EGVB) in liver cirrhosis. Methods Sixty-three patients with cirrhosis and portal hypertension admitted between June 2018 and December 2020 were enrolled in this study. All patients received 3 phases of abdominal enhanced scan (arterial phase, portal vein phase and delayed phase). Energy spectrum scanning mode was started in the portal phase to obtain the best single-energy portal CNR images (the best CNR group) and 70 keV single-energy portal vein images (the 70 keV group), and the portal vein CT values, hepatic parenchyma CT values, portal vein main (MPV) CNR and image quality scores were recorded in these two groups. Kappa consistency test was used to evaluate the consistency between the grade of esophageal and gastric fundus varices diagnosed by the best CNR single energy portal vein image and gastroscopy. Results The CT value of portal vein, CT value of liver parenchyma, MPV CNR and image quality score in the best CNR group were (298.6±32.6)Hu, (165.5±22.6)Hu, (6.6±1.3) and (4.5±0.8)points, respectively, which were significantly higher than those of [144.8±28.4)Hu, (107.9±16.3)Hu, (4.7±1.5) and (4.1±0.7)points in the 70 keV Group, respectively(t=2.987,t=28.235,t=16.407,t=7.596,P<0.05). The Kappa value of the grade of esophageal and gastric varices diagnosed by the best CNR single energy portal vein image and the consistency test of gastroscopy was 0.8 (P<0.05). Conclusion The best CNR technology of energy spectrum CT can provide the best single energy level image, optimize the image quality of portal vein, and contribute to the prediction of EGVB risk.

Key words: Energy spectrum CT, Contrast to noise ratio, Liver cirrhosis, Esophageal and gastric variceal bleeding

ZHANG Peng, ZHANG Guo-fu. The value of energy spectrum CT optimal CNR technique in the diagnosis of esophageal and gastric variceal bleeding in liver cirrhosis[J]. Chinese Hepatolgy, 2021, 26(12): 1351-1352.

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