RESUMO
Objective To explore the clinical value of dual-source CT (DSCT) dual-energy imaging for in vivo diagnosis of gallstone composition. Methods Totally 200 patients with gallstone undergoing cholecystectomy were collected. DSCT dual energy examination was performed preoperatively to analyze the detection rate of 80 kV and 140 kV images for gallbladder negative stones. Taken the results of micro-infrared spectroscopy as golden standards, the 80 kV images CT value, 140 kV images CT value, CT value difference and CT value ratio among different stone composition were compared. The diagnostic efficacy of each indicator in differentiating cholesterol from non-cholesterol gallstone was calculated using ROC curves. Results The detection rate of 80 kV images, 140 kV images and the combined application of both for gallbladder negative stones was 88.89% (80/90), 76.67% (69/90) and 100% (90/90), respectively. The 80 kV images CT value, 140 kV images CT value, CT value difference and CT value ratio of cholesterol composition were all lower than those of bilirubin calcium and rare composition (all P0.05). Taken 62 HU and -2 HU as the threshold of 80 kV images CT value and CT value difference, the sensitivity and specificity in diagnosis of cholesterol and non-cholesterol composition stones were both 100%. Conclusion DSCT dual-energy imaging can be used in accurate identification of gallbladder cholesterol gallstones and non-cholesterol gallstones.