摘要
目的探讨增强CT图像的纹理参数的预测食管鳞癌患者淋巴结转移的可行性。方法选取本院在治疗之前行胸部CT增强扫描的食管鳞癌患者,共纳入51例患者,以术后病理结果为标准,依据有无淋巴结转移分为非淋巴结转移组、淋巴结转移组两组。非淋巴结转移组共24例,其中男20例,女4例,年龄40~77岁(63.5±9.4岁);淋巴结转移组共27例,其中男25例,女2例,年龄48~74岁(63.4±6.5岁)。将增强CT图像(动脉期和静脉期)数据导入FireVoxel软件进行纹理分析,记录各纹理参数值包括均值、中位数、标准差、异质性、偏度、峰度、熵值。依据术后病理结果分为淋巴结转移组、非转移组,比较两组间纹理参数差异,利用ROC曲线分析CT纹理参数鉴别淋巴结转移的价值。结果动脉期不均匀度、熵值在两组之间的差异有统计学意义(P<0.05);静脉期标准差、不均匀度、熵值纹理参数在两组之间的差异具有统计学意义(P<0.05)。动脉期不均匀度、熵值鉴别食管癌淋巴结转移的最佳临界值分别为0.017、3.891,曲线下面积为0.685、0.674。静脉期标准差、不均匀度及熵值对于鉴别食管癌淋巴结转移具有显著性意义,其中以熵值的曲线下面积最大(0.704),其最佳临界值为3.842,敏感度为70.4%,特异度为75%,对于食管癌淋巴结转移的鉴别具有一定的准确性。结论增强CT图像(尤其是静脉期)的纹理分析有助于鉴别食管癌淋巴结转移,为食管癌术前无创性预测淋巴结转移提供帮助。
Objective To explore the feasibility of texture analysis of enhanced CT images to predict the metastasis of lymphonodus in patients with esophageal squamous cell carcinoma. Methods The patients of esophageal squamous cell carcinoma in our hospital were selected. According to the pathological results, the patients were divided into lymphonodus metastasis group and non metastasis group. 51 patients with esophageal squamous cell carcinoma were included, 27 in lymphonodus metastasis group(25 males and 2 females with an average age of 63.4±6.5 years old) and 24 in non metastasis group(20 males and 4 females with an average age of 63.5±9.4 years old). The chest CT enhancement were performed before treatment. The enhanced CT images(arterial phase and venous phase) were imported into the Firevoxel software for texture analysis. The texture parameters were recorded including mean, median, standard deviation, heterogeneity, skewness, kurtosis and entropy. The differences of texture parameters between the two groups were analyzed. The value of CT texture parameters in identifying lymphonodus metastasis was analyzed by ROC curve. Results There were significant differences in heterogeneity and entropy between the two groups in arterial phase(P< 0.05). There were significant differences in standard deviation, heterogeneity and entropy between the two groups in venous phase(P< 0.05). In arterial phase, the optimal cut-off values for the diagnosis of lymph node metastasis of esophageal cancer were heterogeneity and entropy and the areas under the curve were 0.685 and 0.674, respectively. In venous phase, the standard deviation, inhomogeneity and entropy had significant significance in distinguishing lymph node metastasis of esophageal cancer. Among them, the area under the curve of entropy was the largest(0.704), the best critical value was 3.842, the sensitivity was 70.4%, and the specificity was 75%. It had a certain accuracy for the diagnosis of lymph node metastasis of esophageal cancer. Conclusion The texture analysis of
作者
王大伟
董婷宇
霍志云
庞智英
康智勇
朱晓龙
杨飞
WANG Dawei;DONG Tingyu;HUO Zhiyun;PANG Zhiying;KANG Zhiyong;ZHU Xiaolong;YANG Fei(Department of Cardiothoracic Surgery,the First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,China;Department of Medical Imaging,the First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,China)
出处
《分子影像学杂志》
2020年第1期64-69,共6页
Journal of Molecular Imaging
基金
张家口市级科技计划自筹经费项目(1921024D)。
关键词
食管癌
鳞状细胞癌
淋巴结转移
增强CT
纹理分析
esophageal carcinoma
squamous cell carcinoma
lymph node metastasis
enhanced CT
texture analysis
