摘要
目的初步探讨CT纹理分析在鉴别诊断胃肠道异位胰腺与直径小于3 cm的间质瘤中的价值。方法回顾性分析2009年1月至2018年6月经术后病理确诊为胃肠道异位胰腺的23例患者的临床及影像学资料,并纳入同期直径均小于3 cm的23例胃肠道间质瘤患者。分别在CT增强扫描动脉期及静脉期图像对病灶进行手动全层勾画,应用A.K.软件(GE公司,美国)提取动脉期及静脉期纹理特征,采用Pearson相关性分析和Mann-Whitney U检验筛去冗余特征,再通过赤池信息准则(AIC)后退法,选择AIC值对应最小的鉴别模型。绘制动脉期、静脉期及动脉期联合静脉期受试者工作特征(ROC)曲线评估其鉴别效能,计算曲线下面积(AUC)、准确度、敏感度、特异度、阳性预测值及阴性预测值。结果筛选出3个动脉期特征(即峰度,高灰度大面积优势,高灰度小面积优势)及1个静脉期特征(即高灰度大面积优势)。分别建立动脉期、静脉期及动脉期联合静脉期的鉴别诊断模型,可得到动脉期联合静脉期诊断模型的AUC、准确度、特异度和阳性预测值分别为0.91、0.87、0.96和0.95,均高于动脉期和静脉期模型。结论CT纹理分析可用于术前鉴别胃肠道异位胰腺与直径小于3 cm的间质瘤,动脉期联合静脉期模型的鉴别效能最佳。
Objective To investigate the diagnostic value of CT texture analysis(CTTA)in differentiating gastrointestinal heterotopic pancreas and gastrointestinal stromal tumors which are smaller than 3 cm in diameter.Methods We retrospectively analyzed 23 patients who were diagnosed with heterotopic pancreas(proved by pathology)during January 2008 to June 2018.23 gastrointestinal stromal tumors cases that were less than 3 cm in the same period were randomly included.Regions of interest(ROIs)were manually drawn on all slices of arterial and venous contrast-enhanced images and CT texture parameters were extracted in A.K.software(GE company,USA).After removing redundancy by the Pearson correlation coefficient and the Mann-Whitney U test,then with the application of AIC(Akaike information criterion),the model with the minimum AIC value was chosen as the optimal one.Receiver operating characteristic(ROC)analysis was performed to assess the diagnostic performance of logistic model in the arterial phase(AP),portal venous phase(PVP)and arterial phase combined with portal venous phase.Area under curve(AUC),accuracy,sensitivity,specificity,positive predictive value and negative predictive value were calculated.Results Four texture parameters were selected including 3 parameters in arterial phase,namely kurtosis,large zone high gray-level emphasis and small zone high gray-level emphasis,and one parameter in venous phase was large zone high gray-level emphasis.Arterial,portal venous and arterial combined with portal venous model were constructed respectively,and the model that used the combination of AP and PVP images achieved better performance than using either of the two phase alone,yielding an AUC of 0.91,accuracy of 0.87,specificity of 0.96 and positive predictive value of 0.95.Conclusion CTTA can effectively distinguish between gastrointestinal heterotopic pancreas and gastrointestinal stromal tumors less than 3 cm in diameter.The model which combined AP with PVP images had the optimal diagnostic performance.
作者
路鸣
魏赟
史红媛
余静
程申濠
段绍峰
徐青
LU Ming;WEI Yun;SHI Hongyuan(Department of Radiology,First Affiliated Hospital of Nanjing Medical University,Nanjing,Jiangsu Province 210029,P.R.China)
出处
《临床放射学杂志》
CSCD
北大核心
2020年第3期493-496,共4页
Journal of Clinical Radiology
基金
国家自然科学基金青年基金资助项目(编号:81701760)
江苏省青年基金资助项目(编号:BK20171086)
关键词
异位胰腺
间质瘤
CT纹理分析
鉴别
Heterotopic pancreas
Gastrointestinal stromal tumors
CT texture analysis
Differential
