Differentiation of pyogenic hepatic abscesses from malignant mimickers using multislice-based texture acquired from contrast-enhanced computed tomography

BACKGROUND： Pyogenic hepatic abscess may mimic primary or secondary carcinoma of the liver on contrast-enhanced computed tomography（CECT）. The present study was to explore the usefulness of the analysis of multislice-based texture acquired from CECT in the differentiation between pyogenic hepatic abscesses and malignant mimickers.METHODS： This retrospective study included 25 abscesses in 20 patients and 33 tumors in 26 subjects who underwent CECT. To make comparison, we also enrolled 19 patients with hepatic single simple cyst. The images from CECT were analyzed using a Laplacian of Gaussian band-pass filter（5 filter levels with sigma weighting ranging from 1.0 to 2.5）. We also quantified the uniformity, entropy, kurtosis and skewness of the multislice-based texture at different sigma weightings. Statistical significance for these parameters was tested with oneway ANOVA followed by Tukey honestly significant difference（HSD） test. Diagnostic performance was evaluated using the receiver operating characteristic（ROC） curve analysis.RESULTS： There were significant differences in entropy and uniformity at all sigma weightings（P〈0.001） among hepatic abscesses, malignant mimickers and simple cysts. The significant difference in kurtosis and skewness was shown at sigma 1.8 and 2.0 weightings（P=0.002-0.006）. Tukey HSD testshowed that the abscesses had a significantly higher entropy and lower uniformity compared with malignant mimickers（P=0.000-0.004）. Entropy（at a sigma 2.0 weighting） had the largest area under the ROC curve（0.888） in differentiating abscesses from malignant mimickers, with a sensitivity of 81.8% and a specificity of 88.0% when the cutoff value was set to 3.64.CONCLUSION： Multislice-based texture analysis may be useful for differentiating pyogenic hepatic abscesses from malignant mimickers.

CT via percutaneous splenoportography: experiment and application

Objective To introduce computed tomography via percutaneous splenoportography (CTSP), a new method for determining hepatic diseases Methods Ten hybrid dogs and 31 patients with primary hepatic cancer (PHC) were included in the study Each dog was examined by CT, computed tomography via arterial portography (CTAP), and CTSP to compare the enhanced density of the liver The 31 patients were examined by CTSP and the appearanec of PHC was compared with their pathological results to evaluate the diagnostic significance of CTSP Results The animal experiment showed that both CTAP and CTSP could obviously enhance the density of the liver ( P <0 01), but no significant difference was observed in the enhanced densities between the two methods ( P >0 05) On the CTSP images of the 31 patients, the density of the livers was increased to 168-192?Hu, whereas the density of the cancers was as low as that on the images of CT scans (<58?Hu) The CTSP findings were consistent with the surgical ones from space occupying lesions The diagnostic value of CTSP was obviously superior to that of general enhanced CT However, it was difficult for CTSP to show nodules less than 1?cm in size located on the surface of the liver or the hepatic portal zone Conclusions Like CTAP, CTSP is also a sensitive method for showing occupant in the liver But the equipments and the procedures are simpler for CTSP than for CTAP CTSP is an alternative procedure in clinical practice