a. Department of Medical Image丨 b. Department of General Surgery丨 c. Department of Gastroenterology, Bengbu First People’s
Hospital, Bengbu Anhui 233000, China
Abstract：Objective To explore the application value of 256-slice Revolution CT multi-parameter spectrum imaging in the diagnosis
of gallbladder negative stone. Methods The imaging data of 30 patients with suspected gallbladder negative stone diagnosed by
energy spectrum in our hospital were retrospectively collected. All patients underwent cholecystectomy with surgical results as the
reference standard. The energy spectrum software was used to observe the distribution of energy spectrum curves of negative stone,
abdominal fat and bile, and calculate the slope of the curve, to measure and record the CT values of gallbladder negative stones
and adjacent bile in the monochromatic images with energy levels ranging from 40 to 140 keV, and the differences were compared.
Material separation technique (fat/water imaging, iodine/water imaging) were used to observe the negative stone display effect, the
effective atomic numbers of negative stones, abdominal fat and adjacent bile were measured and compared. Based on the results
of gallbladder surgery, the sensitivity, specificity and diagnostic coincidence rate of energy spectrum scanning in the diagnosis of
gallbladder negative stone were calculated, and the consistency of diagnostic results was evaluated by Kappa test. Results Both
negative stones and abdominal fat spectrum curves showed a slow ascending reverse arch. Both curves had similar slope (P>0.05).
The bile energy spectrum curve was horizontal or slightly descending. The curve slope was significantly different from the negative
stone (P<0.05)丨 CT values of negative stone and adjacent bile in low keV single energy images (40~60 keV) and high keV
single energy images (90~140 keV) were significantly different (P<0.05). The effective atomic numbers of negative stones and
adjacent bile were 6.17±1.09 and 8.76±0.34, the difference was statistically significant (P<0.05)丨 Both base substance density
imaging fat/water imaging and iodine/water imaging showed negative stones. The fat water imaging showed a high density shadow,
while the iodine/water imaging showed a low density shadow. The fat/water imaging showed the best result. The sensitivity, specificity
and diagnostic coincidence rates of energy spectrum scanning in the diagnosis of gallbladder negative stones were 93.10%, 100%
and 90.00%, respectively, and the diagnostic results were in good agreement with the results of gallbladder surgery (Kappa=0.817).
Conclusion The 256-slice Revolution CT multi-parameter energy spectrum analysis provides a new method for the clinical diagnosis of gallbladder negative stones, which can significantly improve the detection rate of gallbladder negative stones, with high sensitivity and
specificity, and provides a reference for the clinical development of the next treatment plan. It has important clinical application value.
