摘要
目的通过应用MRI直方图分析技术研究肿瘤纹理改变在胚胎发育不良性神经上皮瘤(dysembryoplastic neuroepithelial tumor,DNET)和弥漫性星形细胞瘤(diffuse astrocytoma,DA)鉴别诊断中的临床应用价值。材料与方法回顾性分析2014年12月至2021年12月在新疆医科大学第一附属医院神经外科接受手术并经病理活检证实的21例DNET和35例DA患者的病例。首先分析两组的常规影像特征,再勾画其术前MRI的T2液体衰减反转恢复序列轴位图像中的瘤体并进行直方图分析,提取瘤体的平均值、中位数、标准差、异质性、峰度、偏度及熵等直方图参数,比较DNET和DA直方图参数并进行统计学分析,观察比较各参数对疾病诊断的功能。结果DNET及DA患者的一般资料如年龄、性别及肿瘤发生部位差异均无统计学意义(P>0.05)。倒三角征影像征象对两组患者进行鉴别诊断差异有统计学意义(P<0.05)。比较DNET和DA的7个直方图参数后发现,二者的平均值、中位数及峰度三个参数差异有统计学意义(P<0.05),其中峰度的单因素鉴别诊断价值意义最大,其受试者工作特征曲线的曲线下面积(area under the curve,AUC)为0.690,敏感度及特异度分别为68.6%和66.7%。对平均值、中位数及峰度进行多参数联合分析,平均值结合峰度的AUC最高,AUC、敏感度及特异度分别为0.721、66.7%及77.1%,因此平均值结合峰度的鉴别诊断效能高于单个直方图分析参数鉴别效能。将倒三角征与直方图分析参数相结合,鉴别诊断效能均明显提高,平均值、中位数、峰度结合倒三角征的鉴别诊断效能最好,AUC值为0.830,敏感度、特异度及准确度分别为85.7%、74.3%及78.6%。结论对于术前MRI检查难以鉴别的DNET和DA,采用直方图分析技术结合倒三角征影像征象可以对二者进行更加准确的鉴别诊断。
Objective:To explore the value of the MRI histogram analysis in differential diagnosis of dysembryoplastic neuroepithelial tumor(DNET)and diffuse astrocytoma(DA).Materials and Methods:The general clinical data and imaging findings of 21 patients with DNET and 35 patients with DA who underwent surgery and were confirmed by pathological biopsy in the Department of Neurosurgery of the First Affiliated Hospital of Xinjiang Medical University from December 2014 to December 2021 were retrospectively analyzed.The conventional imaging features of the two groups were first analyzed,and then the tumors in their preoperative MRI T2 fluid attenuated inversion recovery axial images were outlined and subjected to histogram analysis,and histogram parameters such as mean,median,standard deviation,heterogeneity,kurtosis,skewness and entropy of the tumors were extracted,and the histogram parameters of DNET and DA were compared and statistically analyzed to observe and compare the function of each parameter for disease diagnosis.Results:General information such as age,gender and tumor site of DNET and DA patients were compared,and the differences were not statistically significant(P>0.05).The inverted triangle sign imaging sign was statistically significant for differential diagnosis between the two groups of patients(P<0.05).The difference between the mean,median and kurtosis of DNET and DA was found to be statistically significant(P<0.05),with kurtosis having the greatest univariate differential diagnostic value,with an area under the curve(AUC)value of 0.690 for the receiver operating characteristic curve and sensitivity and specificity of 68.6%and 66.7%,respectively.The AUC of mean combined with kurtosis was the highest,and the AUC,sensitivity and specificity were 0.721,66.7%and 77.1%,respectively.Therefore,the differential diagnostic efficacy of mean combined with kurtosis was higher than that of individual histogram analysis parameters.The differential diagnostic efficacy of combining the inverse triangle sign with the histog
作者
赵伟
丁爽
罕迦尔别克·库锟
王宝龙
王云玲
ZHAO Wei;DING Shuang;HANJIAERBIEKE·Kukun;WANG Baolong;WANG Yunling(Nuclear Magnetic Resonance Room,First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)
出处
《磁共振成像》
CAS
CSCD
北大核心
2022年第7期17-21,54,共6页
Chinese Journal of Magnetic Resonance Imaging
基金
新疆维吾尔自治区科技支疆项目计划(指令性)项目(编号:2020E0275)。
关键词
胚胎发育不良性神经上皮瘤
弥漫性星形细胞瘤
直方图分析
磁共振成像
鉴别诊断
dysembryoplastic neuroepithelial tumor
diffuse astrocytoma
histogram analysis
magnetic resonance imaging
differential diagnosis
