Objective: To investigate the value of spectral CT imaging in the diagnosis and classification of liver cirrhosis during the arterial phase (AP) and portal venous phase (PVP).
Materials and methods: Thirty-eight patients with liver cirrhosis (Child-Pugh class A/B/C: n = 10/14/14), and 43 patients with healthy livers, participated in this study. The researchers used abdominal spectral CT imaging during AP and PVP. Iodine concentration, derived from the iodine-based material-decomposition image and the iodine concentration ratio (IC(ratio)) between AP and PVP, were obtained. Statistical analyses {two-sample t test, One-factor analysis of variance, and area under the receiver operating characteristic curve (A [z])} were performed.
Results: The mean normalized iodine concentration (NIC) (0.5 ± 0.12) during PVP in the control group was significantly higher than that in the study group (0.4 ± 0.10 on average, 0.4 ± 0.08 for Class A, 0.4 ± 0.15 for Class B, and 0.4 ± 0.06 for Class C) (All p < 0.05). Within the cirrhotic liver group, the mean NIC for Class C during the AP (0.1 ± 0.05) was significantly higher than NICs for Classes A (0.1 ± 0.06) and B (0.1 ± 0.03) (Both p < 0.05). The IC(ratio) in the study group (0.4 ± 0.15), especially for Class C (0.5 ± 0.14), was higher than that in the control group (0.3 ± 0.15) (p < 0.05).The combination of NIC and IC(ratio) showed high sensitivity and specificity for differentiating healthy liver from cirrhotic liver, especially in Class C cirrhotic liver.
Conclusion: Spectral CT Provides a quantitative method with which to analyze the cirrhotic liver, and shows the potential value in the classification of liver cirrhosis.
Keywords: Dual-energy CT; Iodine concentration; Liver cirrhosis; Material decomposition; Spectral CT.